Journal
INTERNATIONAL JOURNAL OF NEUROPSYCHOPHARMACOLOGY
Volume 16, Issue 3, Pages 501-506Publisher
CAMBRIDGE UNIV PRESS
DOI: 10.1017/S1461145712000910
Keywords
D-cycloserine; depression; NMDAR; treatment
Funding
- NARSAD Independent Investigator Award
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Antagonism of N-methyl-D-aspartate glutamatergic receptors (NMDAR) may represent an effective antidepressant mechanism. D-cycloserine (DCS) is a partial agonist at the NMDAR-associated glycine modulatory site that at high doses acts as a functional NMDAR antagonist. Twenty-six treatment-resistant major depressive disorder patients participated in a double blind, placebo-controlled, 6-wk parallel group trial with a gradually titrated high dose (1000 mg/d) of DCS added to their antidepressant medication. DCS treatment was well tolerated, had no psychotomimetic effects and led to improvement in depression symptoms as measured by Hamilton Depression Rating Scale (HAMD; p=0.005) and Beck Depression Inventory (p=0.046). Of the 13 subjects treated with DCS, 54% had >= 50% HAMD score reduction vs. 15% of the 13 patients randomized to placebo (p=0.039). A significant (p=0.043) treatmentr pre-treatment glycine serum levels interaction was registered. These findings indicate that NMDAR glycine site antagonism may be a cost-effective target for development of mechanistically novel antidepressants. Larger-sized DCS trials are warranted.
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