Pilot-controlled trial of D-cycloserine for the treatment of post-traumatic stress disorder.
Dysfunction of glutamatergic neurotransmission may be relevant to the pathogenesis of post-traumatic stress disorder (PTSD). Preclinical and clinical evidence suggests that PTSD symptoms could be alleviated following enhancement of neurotransmission mediated at the N-methyl-D-aspartate (NMDA) subtype of glutamate receptors. Eleven patients with chronic PTSD participated in a double-blind, placebo-controlled, cross-over trial with 50 mg/d D-cycloserine which acts as a partial agonist at the glycine regulatory site on the NMDA receptor. D-cycloserine treatment resulted in significant improvements in numbing, avoidance, and anxiety symptoms; however, similar effects were also observed during placebo treatment. In addition, D-cycloserine treatment resulted in a significant (p=0.03), reduction in the perseverative error scores as measured by the Wisconsin Card Sorting Test. This pilot study is the first to assess the efficacy of a NMDA receptor modulator for PTSD treatment and its results warrant further, larger-scale investigation.
Heresco-Levy
Uriel
U
Ezrath Nashim-Herzog Memorial Hospital, and Department of Psychiatry, Hadassah Medical School-Hebrew University, Jerusalem, Israel. heresco@md2.huji.ac.il
Kremer
Ilana
I
Javitt
Daniel C
DC
Goichman
Rodica
R
Reshef
Alon
A
Blanaru
Monica
M
Cohen
Tamar
T
D000328:Adult; D000904:Antibiotics, Antitubercular / Q000627:therapeutic use*; D002908:Chronic Disease; D003071:Cognition / Q000187:drug effects; D018592:Cross-Over Studies; D003523:Cycloserine / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales; D018009:Receptors, Glycine / Q000819:agonists; D013313:Stress Disorders, Post-Traumatic / Q000188:drug therapy* / Q000523:psychology
D000904:Antibiotics, Antitubercular; D018009:Receptors, Glycine; D003523:Cycloserine