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甘氨酸辅助治疗难治性精神分裂症的双盲、安慰剂对照、交叉试验。

Double-blind, placebo-controlled, crossover trial of glycine adjuvant therapy for treatment-resistant schizophrenia.

作者信息

Heresco-Levy U, Javitt D C, Ermilov M, Mordel C, Horowitz A, Kelly D

机构信息

Ezrath Nashim-Herzog Memorial Hospital, Hadassah Medical School-Hebrew University, Jerusalem, Israel.

出版信息

Br J Psychiatry. 1996 Nov;169(5):610-7. doi: 10.1192/bjp.169.5.610.

Abstract

BACKGROUND

It has been proposed that schizophrenia is associated with underactivity of brain glutamatergic neurotransmission, especially at the level of the N-methyl-D-aspartate (NMDA) subtype of glutamate receptor. Glycine potentiates NMDA receptor-mediated neurotransmission, indicating that it may serve as an effective therapeutic agent in the treatment of schizophrenia.

METHOD

Eleven treatment-resistant patients with chronic schizophrenia completed a double-blind, placebo-controlled, six-week, randomly assigned, crossover treatment trial of 0.8 g/kg body weight/day of glycine, added to their prior antipsychotic treatment.

RESULTS

Glycine was well tolerated, resulted in significantly increased serum glycine levels and induced a mean 36 (7%) reduction in negative symptoms (P < 0.0001). Significant improvements were also induced in depressive and cognitive symptoms. The greatest reduction in negative symptoms was registered in the patients who had the lowest baseline serum glycine levels.

CONCLUSIONS

These results extend previous findings and suggest an additional approach to the pharmacotherapy of negative symptoms and cognitive deficits in schizophrenia.

摘要

背景

有观点认为精神分裂症与大脑谷氨酸能神经传递活动不足有关,尤其是在谷氨酸受体的N-甲基-D-天冬氨酸(NMDA)亚型水平。甘氨酸可增强NMDA受体介导的神经传递,这表明它可能是治疗精神分裂症的有效治疗药物。

方法

11例难治性慢性精神分裂症患者完成了一项双盲、安慰剂对照、为期六周、随机分组的交叉治疗试验,在其先前抗精神病治疗基础上加用0.8 g/kg体重/天的甘氨酸。

结果

甘氨酸耐受性良好,导致血清甘氨酸水平显著升高,并使阴性症状平均减少36%(7%)(P < 0.0001)。抑郁和认知症状也有显著改善。阴性症状减少最多的是基线血清甘氨酸水平最低的患者。

结论

这些结果扩展了先前的发现,并提示了一种治疗精神分裂症阴性症状和认知缺陷的药物治疗新方法。

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