D-serine added to antipsychotics for the treatment of schizophrenia
D-serine added to antipsychotics for the treatment of schizophrenia
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DOI：
10.1016/s0006-3223(98)00279-0
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发表时间：
1998-12-01
影响因子：
10.6
通讯作者：
Coyle, JT
中科院分区：
文献类型：
--
作者：
Tsai, GC;Yang, PC;Coyle, JT
背景：N-甲基-D-天冬氨酸（NMDA）亚型谷氨酸受体功能低下与精神分裂症的病理生理有关。D-丝氨酸是NMDA受体甘氨酸位点的完全激动剂，所有内源性共递质都富集在皮质边缘区，并与NMDA受体平行分布。补充D-丝氨酸可以改善精神分裂症的症状。方法：31名台湾精神分裂症患者参加了为期6周的双盲，安慰剂对照试验的D-丝氨酸（30 mg/kg/天），这是添加到他们的稳定的抗精神病药物治疗方案。其中，28人完成了试验，每隔一周测定临床疗效、副作用以及血清氨基酸和D-丝氨酸水平。在试验开始和结束时进行威斯康星州卡片分类测验（WCST）。结果：接受D-丝氨酸治疗的患者在阳性、阴性和认知症状方面均有显著改善，WCST也有一定的表现。第4周和第6周的D-丝氨酸水平显著预测了改善。D-丝氨酸耐受性良好，没有显着的副作用noted.Conclusions：与D-丝氨酸的显着改善进一步支持NMDA受体功能减退的精神分裂症的假设。鉴于D-丝氨酸对阳性症状的影响，应考虑单独使用D-丝氨酸治疗精神分裂症。(C)1998年：生物精神病学学会。
Background: Hypofunction of N-methyl-D-aspartate (NMDA) subtype glutamate receptor has been implicated in the pathophysiology of schizophrenia. D-serine is a full agonist of the glycine site of NMDA receptor, all endogenous cotransmitter enriched in corticolimbic regions and distributed in parallel with NMDA receptor. Supplementation of D-serine may improve the symptoms of schizophrenia.Methods: Thirty-one Taiwanese schizophrenic patients enrolled in a 6-week double-blind, placebo-controlled trial of D-serine (30 mg/kg/day), which was added to their stable antipsychotic regimens. Of these, 28 completed the trial, Measures of clinical efficacy, side effects, and serum levels of amino acids and D-serine were determined every other week. Wisconsin Card Sorting Test (WCST) was performed at the beginning and end of the trial.Results: Patients who received D-serine treatment revealed significant improvements in their positive, negative, and cognitive symptoms as well as some performance in WCST. D-serine levels at week 4 and 6 significantly predicted the improvements. D-serine was well tolerated and no significant side effects were noted.Conclusions: The significant improvement with the D-serine further supports the hypothesis of NMDA receptor hypofunction in schizophrenia. Given the effects of D-serine on positive symptoms, a trial of D-serine alone in schizophrenia should be considered. (C) 1998 Society: of Biological Psychiatry.