在精神分裂症阴性症状治疗中，将D-环丝氨酸添加到抗精神病药物中的剂量探索试验。
Dose-finding trial of D-cycloserine added to neuroleptics for negative symptoms in schizophrenia.
作者信息
Goff D C, Tsai G, Manoach D S, Coyle J T
机构信息
Erich Lindemann Mental Health Center, Department of Psychiatry, Massachusetts General Hospital, Boston.
出版信息
Am J Psychiatry. 1995 Aug;152(8):1213-5. doi: 10.1176/ajp.152.8.1213.
OBJECTIVE
The authors conducted a dose-finding study of D-cycloserine, a partial agonist at the glycine site of the N-methyl-D-aspartate subtype of the glutamate receptor, added to conventional neuroleptics for schizophrenic patients with prominent negative symptoms.
METHOD
Nine patients with schizophrenia completed consecutive 2-week trials of placebo and four doses of D-cycloserine. Clinical assessments were videotaped and were scored by a rater who was blind to temporal sequence.
RESULTS
D-Cycloserine at a dose of 50 mg/day produced a significant reduction (mean = 21%, SD = 28%) in negative symptoms and significantly improved reaction time as measured by Sternberg's Item Recognition Paradigm, a test mediated in part by prefrontal cortex.
CONCLUSIONS
This preliminary evidence suggests that D-cycloserine may improve negative symptoms and cognitive deficits over a narrow dose range when added to conventional antipsychotic agents.
目的
作者开展了一项剂量探索研究，将谷氨酸受体N-甲基-D-天冬氨酸亚型甘氨酸位点的部分激动剂D-环丝氨酸添加到传统抗精神病药物中，用于治疗具有明显阴性症状的精神分裂症患者。
方法
9例精神分裂症患者完成了安慰剂及4种剂量D-环丝氨酸的连续2周试验。临床评估过程进行了录像，由对时间顺序不知情的评估者评分。
结果
每日剂量为50毫克的D-环丝氨酸使阴性症状显著减轻（均值=21%，标准差=28%），并显著改善了反应时间，这是通过斯特恩伯格项目识别范式测量得出的，该测试部分由前额叶皮层介导。
结论
这一初步证据表明，当添加到传统抗精神病药物中时，D-环丝氨酸可能在较窄的剂量范围内改善阴性症状和认知缺陷。
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