Attari Abbas, Rajabi Fatemeh, Maracy Mohammad Reza
Behavioral Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
J Res Med Sci. 2014 Jul;19(7):592-8.
Posttraumatic stress disorder (PTSD) tends to follow a chronic and treatment resistant course. Avoidance and numbing are symptoms associated with chronicity and impaired life quality. As D-cycloserine (DCS) can facilitate extinction of conditioned fear, we aimed to investigate the efficacy and tolerability of DCS for the treatment of numbing and avoidance in chronic PTSD.
This was an 11-week, double-blind, cross-over trial conducted in 2012 and 2013, in out-patient University psychiatry clinics. The studied population was selected randomly among outpatients with chronic combat-related PTSD (based on DSM-IV-TR criteria for chronic PTSD), who were males over 18 and <65 years of age (n = 319). Seventy six eligible patients were randomly assigned to two groups. Patients entered a 1-week run-in period. The groups received either an add-on treatment of DCS (50 mg daily), or placebo (4-week). After a 2-week washout, the groups received cross-over treatments (4-week). Clinical, paraclinical assessments, and clinician administered PTSD scale (CAPS) were performed at baseline, and at the end of the 1(st), 5(th), and 11(th) week. Side-effects were also evaluated. The overall number of avoidance and numbing symptoms, symptom frequency, and symptom intensity were measured separately.
Neither frequency nor number of symptoms was significantly influenced. However, DCS treatment demonstrates a significant decrease in intensity of avoidance/numbing symptoms, and improvement in function (mean [standard error] = -4.2 [1.5], P = 0.008). Side-effects were not statistically remarkable.
D-cycloserine can help as an adjunctive treatment to alleviate numbing and avoidance in combat-related chronic PTSD.
创伤后应激障碍（PTSD）往往呈慢性病程且难治。回避和麻木是与慢性病程及生活质量受损相关的症状。由于D - 环丝氨酸（DCS）可促进条件性恐惧的消退，我们旨在研究DCS治疗慢性PTSD中麻木和回避症状的疗效及耐受性。
这是一项于2012年和2013年在大学门诊精神科诊所进行的为期11周的双盲交叉试验。研究人群从患有慢性战斗相关PTSD（基于DSM - IV - TR慢性PTSD标准）的门诊患者中随机选取，患者为年龄在18岁以上且小于65岁的男性（n = 319）。76名符合条件的患者被随机分为两组。患者进入为期1周的导入期。两组分别接受DCS（每日50毫克）附加治疗或安慰剂治疗（4周）。经过2周的洗脱期后，两组接受交叉治疗（4周）。在基线以及第1、5和11周结束时进行临床、辅助临床评估以及临床医生评定的PTSD量表（CAPS）评估。同时评估副作用。分别测量回避和麻木症状的总数、症状频率及症状强度。
症状的频率和数量均未受到显著影响。然而，DCS治疗显示回避/麻木症状强度显著降低，功能有所改善（均值[标准误]= -4.2[1.5]，P = 0.008）。副作用无统计学差异。
D - 环丝氨酸可作为辅助治疗帮助减轻与战斗相关的慢性PTSD中的麻木和回避症状。
