Psychotic Disorders Clinical Trial
Official title:
NMDA Enhancers in the Treatment of Schizophrenia: Sarcosine vs. D-Serine
Both GlyT-1 inhibitors and NMDA-glycine site agonists have been demonstrated to be
beneficial for chronic schizophrenia patients.
The purpose of this study is to compare efficacy and safety of add-on treatment of
sarcosine, a GlyT-1 inhibitor, and D-serine, an NMDA-glycine site agonist, in chronically
stable schizophrenia patients who have been stabilized with antipsychotics.
The etiology of schizophrenia remains unclear. Schizophrenia patients reveal positive
symptoms, negative symptoms, and cognitive impairments. In addition to dopamine system
hyperactivity, hypofunction of N-methyl-D-aspartate (NMDA) receptor plays a role in the
pathophysiology of schizophrenia. Consequently, enhancing NMDA receptor neurotransmission
has been regarded as a novel treatment approach. To date, there have been several reported
trials on NMDA enhancers. Both sarcosine (N-methylglycine, a glycine transporter I
inhibitor) and D-serine (a potent NMDA-glycine site agonist) showed therapeutic effects in
chronically stable patients. Interestingly, sarcosine appeared more efficacious than
D-serine in acutely exacerbated ones when added-on to antipsychotics. Both sarcosine and
D-serine yielded excellent safety profiles.
It remains unclear whether sarcosine can be also more efficacious than D-serine in the
treatment for chronically stable schizophrenia. The aim of this project is to examine the
efficacy and safety of add-on treatment of sarcosine vs. D-serine in chronically stable
schizophrenia patients who have been stabilized with antipsychotics.
In the study, 60-75 schizophrenic patients are recruited into the 6-week trial and randomly
assigned into the three groups (2 gm/d sarcosine, 2 gm/d D-serine, or placebo) with a
double-blind manner. Clinical manifestation (Positive and Negative Syndrome Scale [PANSS],
side effects and quality of life (QOL) are evaluated every two weeks during the trial.. The
efficacies of three groups are compared.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double-Blind, Primary Purpose: Treatment
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