Lane Hsien-Yuan, Liu Yi-Ching, Huang Chieh-Liang, Chang Yue-Cune, Liau Chun-Hui, Perng Cheng-Hwang, Tsai Guochuan E
Department of Psychiatry, China Medical University and Hospital, Taichung, Taiwan.
Biol Psychiatry. 2008 Jan 1;63(1):9-12. doi: 10.1016/j.biopsych.2007.04.038. Epub 2007 Jul 20.
Small molecules that enhance the N-methyl-D-aspartate (NMDA) neurotransmission have been shown to be beneficial as adjuvant therapy for schizophrenia. Among these compounds, sarcosine (a glycine transporter-I inhibitor), when added to an existing regimen of antipsychotic drugs, has shown its efficacy for both chronically stable and acutely ill patients. However, the efficacy of these agents as a primary antipsychotic agent has not yet been demonstrated.
Twenty acutely symptomatic drug-free patients with schizophrenia were randomly assigned under double-blind conditions to receive a 6-week trial of 2 g or 1 g of sarcosine daily.
Overall, patients in the 2-g group were more likely to respond as defined by a 20% or more reduction of the Positive and Negative Syndrome Scale total score, particularly among antipsychotic-naïve patients. However, there was no significant between-group difference in the sarcosine dose x time interaction analysis. Both doses were well tolerated with minimal side effects.
Although patients receiving the 2-g daily dose were more likely to respond, it requires further clarification whether the effect is limited to the antipsychotic-naive population. Future placebo- or active-controlled, larger-sized studies are needed to fully assess sarcosine's effects.
已证明增强N-甲基-D-天冬氨酸（NMDA）神经传递的小分子作为精神分裂症的辅助治疗是有益的。在这些化合物中，肌氨酸（一种甘氨酸转运体-I抑制剂），当添加到现有的抗精神病药物治疗方案中时，已显示出对慢性稳定和急性病患者均有效。然而，这些药物作为主要抗精神病药物的疗效尚未得到证实。
20名有急性症状的未服用过药物的精神分裂症患者在双盲条件下被随机分配，接受为期6周的每日2克或1克肌氨酸的试验。
总体而言，2克组的患者更有可能出现反应，定义为阳性和阴性症状量表总分降低20%或更多，特别是在未服用过抗精神病药物的患者中。然而，在肌氨酸剂量×时间交互分析中，组间没有显著差异。两种剂量的耐受性都很好，副作用最小。
虽然接受每日2克剂量的患者更有可能出现反应，但这种效果是否仅限于未服用过抗精神病药物的人群还需要进一步澄清。未来需要进行安慰剂对照或活性对照的更大规模研究，以全面评估肌氨酸的效果。
