a Department of Psychiatry , Yale University School of Medicine , New Haven , Connecticut , USA.
J Dual Diagn. 2019 Jan-Mar;15(1):46-55. doi: 10.1080/15504263.2018.1549764. Epub 2019 Jan 11.
The hypofunctioning of N-methyl-D-aspartate (NMDA) receptors are thought to play an important role in the pathophysiology of schizophrenia. The augmentation of the glutamatergic system through the NMDA receptor may attenuate alcohol craving and use. This study was designed to evaluate the efficacy of glycine, an agonist of the glycine B co-agonist site of the NMDA receptor on alcohol consumption and cravings as well as on negative symptoms in schizophrenia. Participants ( = 20) were given 0.8 g/kg glycine or matching placebo (provided in bottles with mixed in solution) each week for the duration of the 12-week trial. Primary outcome measures included drinking, craving for alcohol, and symptoms of schizophrenia. Cognitive functioning (attention, concentration, and memory) was also evaluated. Glycine showed no benefit over placebo in the reduction of heavy drinking days or craving for alcohol over a 12-week treatment period. Nor was there an effect on negative symptoms of schizophrenia or on cognitive functioning. Although our study showed no beneficial effect of glycine over placebo, our results are consistent with the largest trial of glycine treatment in schizophrenia. Diagnosed schizophrenia and alcohol dependence might be more difficult to treat because of more severe psychopathology. This is the first study to date to examine an innovative treatment approach with an amino acid, glycine, as potentially acting on both alcohol intake and negative symptoms of schizophrenia.
N-甲基-D-天冬氨酸(NMDA)受体功能低下被认为在精神分裂症的病理生理学中发挥重要作用。通过 NMDA 受体增强谷氨酸能系统可能会减轻酒精渴求感和饮酒量。本研究旨在评估甘氨酸(NMDA 受体甘氨酸 B 协同激动剂位点的激动剂)对精神分裂症患者的酒精消费和渴求感以及阴性症状的疗效。参与者( = 20)在 12 周的试验期间每周接受 0.8 g/kg 甘氨酸或匹配的安慰剂(在装有混合溶液的瓶子中提供)。主要观察指标包括饮酒量、对酒精的渴求感和精神分裂症症状。认知功能(注意力、专注力和记忆力)也进行了评估。甘氨酸在减少重度饮酒天数或 12 周治疗期间对酒精的渴求感方面没有优于安慰剂的效果。对精神分裂症的阴性症状或认知功能也没有影响。尽管我们的研究表明甘氨酸与安慰剂相比没有有益的效果,但我们的结果与甘氨酸治疗精神分裂症的最大试验一致。诊断为精神分裂症和酒精依赖的患者可能更难治疗,因为他们的精神病理学更严重。这是迄今为止首次研究氨基酸甘氨酸作为一种可能同时作用于酒精摄入和精神分裂症阴性症状的创新治疗方法。