CYCLOSERINE AND CYPROHEPTADINE TREATMENT OF DEPERSONALIZATION

本子项目是利用由NIH/NCRR资助的中心赠款提供的资源的众多研究子项目之一。子项目和研究者（PI）可能已经从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。列出的机构是中心的，不一定是研究者的机构。人格解体障碍（DPD）是一种慢性、致残的精神疾病，其特征是与自我感觉疏远、分离和脱节。目前，还没有批准用于治疗DPD的药物。不幸的是，最近的对照试验表明，SSRI和拉莫三嗪在DPD中均呈阴性。目前对该疾病进行的最先进的精神药理学治疗没有经过证实的疗效或任何药物的系统指南。药理学家通常根据每个患者的症状和合并症概况尝试使用各种已上市的药物。然而，基于理论推理和病例报告数据，有理由假设NMDA部分甘氨酸激动剂d -环丝氨酸（DCS）和5HT2A和C拮抗剂赛庚啶（CH）可能对DPD有一定疗效。因此，我们建议进行一项试验性交叉药物治疗研究，包括8周DCS开放治疗组和8周CH开放治疗组，在15名目前患有DSM-IV人格解体的受试者中按随机顺序给予治疗，并有2周的洗脱期。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Depersonalization disorder (DPD) is a chronic, disabling psychiatric condition that is characterized by feelings of estrangement, detachment, and disconnection from one's sense of self. Currently, there are no approved pharmacological agents for the treatment of DPD. Recent controlled trials of both SSRI and lamotrigine in DPD unfortunately proved negative. State-of-the-art psychopharmacologic treatment for the disorder is currently conducted without proven efficacy or systematic guidelines for any medication. Pharmacologists usually attempt to use a variety of marketed medications on the basis of the symptom and comorbidity profile of each individual patient. However, based both on theoretical reasoning and case report data, there is reason to hypothesize that the NMDA partial glycine agonist D-cycloserine (DCS) and the 5HT2A and C antagonist cyproheptadine (CH) may have some efficacy in the treatment of DPD. We therefore propose to conduct a pilot crossover medication treatment study consisting of an 8-week open treatment arm with DCS and an 8-week open treatment arm with CH, administered in randomized sequence with a 2-week washout period in 15 subjects currently suffering from DSM-IV depersonalization.