Pilot-controlled trial of D-cycloserine for the treatment of post-traumatic stress disorder
Pilot-controlled trial of D-cycloserine for the treatment of post-traumatic stress disorder
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DOI：
10.1017/s1461145702003061
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发表时间：
2002-12-01
影响因子：
4.8
通讯作者：
Cohen, T
中科院分区：
文献类型：
--
作者：
Heresco-Levy, U;Kremer, I;Cohen, T
谷氨酸能神经传递功能障碍可能与创伤后应激障碍（PTSD）的发病机制有关。临床前和临床证据表明，通过增强谷氨酸受体 N-甲基-D-天冬氨酸 (NMDA) 亚型介导的神经传递，可以缓解 PTSD 症状。 11 名慢性 PTSD 患者参加了一项双盲、安慰剂对照、交叉试验，试验剂量为 50 mg/d D-环丝氨酸，D-环丝氨酸作为 NMDA 受体甘氨酸调节位点的部分激动剂。 D-环丝氨酸治疗显着改善麻木、回避和焦虑症状；然而，在安慰剂治疗期间也观察到类似的效果。此外，D-环丝氨酸治疗可显着（p=0.03）降低威斯康星卡片分类测试测量的持续错误分数。这项试点研究是第一个评估 NMDA 受体调节剂治疗 PTSD 疗效的研究，其结果值得进一步、更大规模的研究。
Dysfunction of glutamatergic neurotransmission may be relevant to the pathogenesis of post-traumatic stress disorder (PTSD). Preclinical and clinical evidence suggests that PTSD symptoms could be alleviated following enhancement of neurotransmission mediated at the N-methyl-D-aspartate (NMDA) subtype of glutamate receptors. Eleven patients with chronic PTSD participated in a double-blind, placebo-controlled, cross-over trial with 50 mg/d D-Cycloserine which acts as a partial agonist at the glycine regulatory site on the NMDA receptor. D-cycloserine treatment resulted in significant improvements in numbing, avoidance, and anxiety symptoms; however, similar effects were also observed during placebo treatment. In addition, D-cycloserine treatment resulted in a significant (p=0.03), reduction in the perseverative error scores as measured by the Wisconsin Card Sorting Test. This pilot study is the first to assess the efficacy of a NMDA receptor modulator for PTSD treatment and its results warrant further, larger-scale investigation.