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Glutamatergic drugs for schizophrenia
H J Tuominen1, J Tiihonen, K Wahlbeck
1University of Helsinki, Helsinki, Finland. hxtuomin@mappi.helsinki.fi
The Cochrane Database of Systematic Reviews
|April 21, 2006
Summary
Glutamatergic drugs like glycine and D-serine may offer modest improvements for negative symptoms in schizophrenia. However, these findings are inconsistent, and these drugs do not appear to reduce positive symptoms.
Area of Science:
- Neuroscience
- Psychiatry
- Pharmacology
Background:
- Central nervous system dopamine plays a key role in schizophrenia pathophysiology.
- Brain glutamate is implicated in schizophrenia symptoms by influencing dopaminergic transmission.
- Glutamatergic drugs may potentially alleviate negative and cognitive symptoms of schizophrenia.
Purpose of the Study:
- To evaluate the effectiveness of glutamatergic medications in treating schizophrenia.
- To synthesize evidence from randomized controlled trials on glutamatergic drug efficacy for schizophrenia.
Main Methods:
- Searched Cochrane Schizophrenia Group's Trials Register and relevant references.
- Included randomized controlled trials administering glutamatergic medication to schizophrenia patients.
- Extracted data, performed quality rating, and analyzed dichotomous data using relative risks and confidence intervals.
Main Results:
- Eighteen short-term trials (358 participants) augmented antipsychotic treatment with glycine, D-serine, D-cycloserine, or CX516.
- D-cycloserine showed no efficacy; glycine and D-serine demonstrated moderate effects on negative symptoms (SMD -0.66).
- Responder rates for negative symptoms were inconsistent; no significant effects on positive symptoms or cognitive function were observed.
Conclusions:
- Glutamatergic drugs generally did not reduce positive symptoms when added to antipsychotic treatment.
- Glycine and D-serine may offer some improvement in negative symptoms, but data are limited and inconsistent.
- Further research is needed, considering potential reduced response in treatment-resistant populations.
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