Conditioning nausea in a laboratory setting: A pilot study

Cancer patients can experience nausea as they approach the place where they have received chemotherapy treatment. This nausea is likely the result of Pavlovian conditioning, where the previously neutral environment acquires conditioned properties, in this case conditioned nausea, because its association with feeling ill. To investigate this phenomenon under controlled conditions, we studied the acquisition of conditioned nausea using a distinct environment paired with an emetic drug in healthy young adults. We measured two indices of conditioning: i) conditioned place aversion, and ii) conditioned drug-like (nausea) responses. Healthy volunteers (N=32) first rated their preference for two testing rooms, and then underwent four conditioning sessions in which they received either syrup of ipecac (5 ml) or placebo. A Paired Group (PG; N=17) always received ipecac in their initially preferred room and placebo in the other, while an Unpaired Group (UG; N=15) received ipecac and placebo in both rooms. Conditioned responses were assessed with i) time spent in each room, ii) room liking and preference, and iii) feelings of nausea in each room. There was no evidence of conditioned place aversion as measured by either time spent or ratings of room liking. However, the PG did report a small increase in nausea in the ipecac-paired room. Although the conditioned responses in this study were not robust, this procedure is a first step towards studying conditioned aversive drug responses in humans, which will enable development of future studies to prevent or treat anticipatory nausea.