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Pilot controlled trial of d-serine for the treatment of post-traumatic stress disorder

Uriel Heresco-Levy, Agnes Vass, Boaz Bloch, Herman Wolosker, Elena Dumin, Livia Balan, Lisa Deutsch, Ilana Kremer
DOI: http://dx.doi.org/10.1017/S1461145709000339 1275-1282 First published online: 1 October 2009

Abstract

Enhancement of neurotransmission mediated at N-methyl-d-aspartate subtype of glutamate receptors (NMDAR) may be beneficial in post-traumatic stress disorder (PTSD). d-serine (DSR) is an endogenous full agonist at the NMDAR-associated glycine modulatory site. Twenty-two chronic PTSD outpatients were randomly assigned to participate in a 6-wk double-blind, placebo-controlled, crossover trial with 30 mg/kg.d DSR used as monotherapy or add-on pharmacotherapy. Outcome was assessed using the Clinician-Administered PTSD scale (CAPS), Hamilton Anxiety (HAMA) and Depression (HAMD) scales and the civilian version of the Mississippi Scale for Combat-Related PTSD (MISS). DSR treatment was well tolerated and resulted in significantly (p=0.03) increased DSR serum levels. Compared with placebo administration, DSR treatment resulted in significantly reduced HAMA (p=0.007) and MISS (p=0.001) scores and a trend (p=0.07) towards improved CAPS total scores. These preliminary findings indicate that NMDAR glycine site-based pharmacotherapy may be effective in PTSD and warrant larger-sized clinical trials with optimized DSR dosages.

Key words
  • d-serine
  • NMDAR
  • PTSD
  • treatment efficacy
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