Alcohol Dependence Clinical Trial
Official title:
Glycine and Oral D-Cycloserine in Alcoholic Patients and Healthy Subjects
Question #1: Will glycine ameliorate cognitive deficits? Hypothesis #1: Based on positive
findings conducted with glycine and milacemide, a glycine prodrug, in schizophrenia and
dementia, we expect that glycine will ameliorate cognitive deficits.
Question #2: Will alcoholic patients show enhanced endocrinal effects to glycine? Hypothesis
#2: Based on the dose-related effects of glycine in healthy subjects, we expect that glycine
will increase the endocrinal response to glycine in alcoholic patients with, supposedly,
dysregulated NMDA receptor function.
Question #3: Will D-cycloserine have ethanol-like effects? Hypothesis #3: If inhibition of
NMDA receptor function is fundamental to the subjective effects of ethanol, then the NMDA
antagonist properties of D-cycloserine should be recognized as ethanol-like (relative to
placebo) in recently detoxified alcoholics and healthy subjects.
Question #4: Will D-cycloserine reverse cognitive benefits of glycine? Hypothesis 4: Based
on the dose related NMDA antagonist activity of D-cycloserine, we expect that D-cycloserine
will compete with the agonist activity of glycine and therefore it will reverse the
cognitive benefits of glycine.
Question #5: Will D-cycloserine inhibit endocrinal effects of glycine? Hypothesis #5: If the
agonist activity of glycine is necessary to determine endocrine response, then the
dose-related NMDA antagonist properties of D-cycloserine should block these effects.
The purpose of this study is to investigate the interaction between glycine and D-cycloserine in alcoholic patients and healthy subjects. Preclinical studies have shown that compounds acting at the glycine site of the N-methyl-D-aspartate (NMDA) receptor complex, such as glycine, may reverse the effects of ethanol on the NMDA receptor function (Rabe et al., 1990). The amino acid glycine is a co-agonist of the NMDA receptor complex (Kemp et al., 1993). It binds to the strychnine-insensitive site and positively modulates the NMDA receptor (Mc Donald et al., 1990). Physiologically, the glycine site is not saturated, and administration of glycine can potentiate NMDA receptor mediated responses. In contrast, D-cycloserine (Hood et al., 1989) is a partial-agonist at the glycine site of the NMDA receptor, with dose-dependent NMDA antagonist properties. The NMDA antagonist activity of D-cycloserine should produce ethanol like-effects that can be reversed by the agonist glycine. This study is intended to evaluate possible contributions of the glycine site to the reduction of cognitive deficits of alcoholism and complements the current work at VA Connecticut Healthcare System on the NMDA antagonists in alcoholic and healthy subjects. ;
Allocation: Randomized, Endpoint Classification: Pharmacokinetics/Dynamics Study, Intervention Model: Crossover Assignment, Masking: Double Blind (Subject, Outcomes Assessor), Primary Purpose: Prevention
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