大型抑郁症的辅助d-氨酸治疗:一个随机临床试验
Lukas Sempach1, Anna-Chiara Schaub2, Annette B Brühl3
1Translational Neuroscience, Department of Clinical Research (DKF), University of Basel, Basel, Switzerland; Translational Psychiatry, Department of Clinical Research (DKF), University of Basel, Basel, Switzerland; University Psychiatric Clinics Basel (UPK), University of Basel, Basel, Switzerland.
Journal of affective disorders
|May 28, 2025
概括
当与标准治疗一起使用时,D-氨酸显示出严重主要抑郁障碍 (MDD) 的潜力. 虽然整体上并不优于安慰剂,但它改善了一些患者的症状,表明有针对性的好处.
科学领域:
- 神经科学是一个神经科学.
- 精神病学是一个精神病学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 谷氨酸性神经递质是主要抑郁症 (MDD) 治疗的主要点.
- N-甲基-d-酸盐受体 (NMDAR) 抗剂表现出抗抑郁作用.
- 作为NMDAR联合激动剂的D-素可以增强现有疗法,并减少副作用.
研究的目的:
- 评估d-serine作为抑郁症状,焦虑和中度至重度MDD中无情症的补充疗法的有效性.
- 评估d-serine对临床医生评级和自我报告结果的影响.
- 为了探索d-serine对中度至重度重度抑郁症患者的影响.
主要方法:
- 一项为期六周的随机,双盲,安慰剂对照试验,涉及44名中度至重度MDD的成年住院患者.
- 参与者每天接受2g的d-serine或安慰剂,与通常治疗 (TAU) 相结合.
- 主要结局:汉密尔顿抑郁评分量表 (HDRS-17) 的变化;次要结局:贝克抑郁量表 (BDI-II),州道焦虑量表 (STAI-1),斯奈思-汉密尔顿快乐量表 (SHAPS).
主要成果:
- 无论是d-serine还是安慰剂组都显示出显著的症状减少,治疗方法之间没有总体差异.
- 亚组分析显示,d-氨酸显著改善了严重MDD患者的抑郁症状.
- 在接受d-serine的重症MDD小组中观察到改善无情的趋势. 与基线抑郁症严重程度和TAU剂量相关的改善.
结论:
- 在整体MDD患者样本中,D-氨酸没有显示出比安慰剂更高的疗效.
- 作为严重MDD的辅助治疗方法,D-氨酸显示出有前途,特别是在与更高剂量的标准药物相结合时.
- 这些发现表明d-氨酸在特定的MDD亚组中具有潜在的协同效应,需要进一步调查.
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