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    Title: Sarcosine therapy for obsessive compulsive disorder: A prospective, open-label study
    Authors: Wu, P.-L.;Tang, Hwa-Sheng;Lane, H.-Y.;Tsai, C.-A.;Tsai, G.E.
    湯華盛
    Contributors: 心理系
    Keywords: alprazolam;amitriptyline;citalopram;clomipramine;clonazepam;escitalopram;fluoxetine;fluvoxamine;haloperidol;imipramine;olanzapine;paroxetine;risperidone;sarcosine;serotonin uptake inhibitor;sertraline;valproic acid;venlafaxine;zotepine;adult;article;clinical article;drug response;drug tolerability;drug withdrawal;dysthymia;female;headache;human;major depression;male;monotherapy;obsessive compulsive disorder;open study;priority journal;prospective study;Adult;Drug Therapy, Combination;Female;Glycine Plasma Membrane Transport Proteins;Humans;Male;Middle Aged;Obsessive-Compulsive Disorder;Psychiatric Status Rating Scales;Psychotropic Drugs;Sarcosine
    Date: 2011-06
    Issue Date: 2015-05-18 17:35:19 (UTC+8)
    Abstract: Background: Several lines of evidence implicate glutamatergic neurotransmission in the pathophysiology of obsessive compulsive disorder (OCD). Sarcosine is an endogenous antagonist of glycine transporter-1. By blocking glycine uptake, sarcosine may increase the availability of synaptic glycine and enhance N-methyl-d-aspartate (NMDA) subtype glutamatergic neurotransmission. In this 10-week open-label trial, we examined the potential benefit of sarcosine treatment in OCD patients. Method: Twenty-six outpatients with OCD and baseline Yale-Brown Obsessive Compulsive Scale (YBOCS) scores higher than 16 were enrolled. Drug-naive subjects (group 1, n = 8) and those who had discontinued serotonin reuptake inhibitors for at least 8 weeks at study entry (group 2, n = 6) received sarcosine monotherapy. The other subjects (group 3, n = 12) received sarcosine as adjunctive treatment. A flexible dosage schedule of sarcosine 500 to 2000 mg/d was applied. The primary outcome measures were Y-BOCS and Hamilton Anxiety Inventory, rated at weeks 0, 2, 4, 6, 8, and 10. Results were analyzed by repeated-measures analysis of variance. Results: Data of 25 subjects were eligible for analysis. The mean ± SD Y-BOCS scores decreased from 27.6 ± 5.8 to 22.7 ± 8.7, indicating a mean decrease of 19.8% ± 21.7% (P = 0.0035). Eight (32%) subjects were regarded as responders with greater than 35% reduction of Y-BOCS scores. Five of the responders achieved the good response early by week 4. Although not statistically significant, drug-naive (group 1) subjects had more profound and sustained improvement and more responders than the subjects who had received treatment before (groups 2 and 3). Sarcosine was tolerated well; only one subject withdrew owing to transient headache. Conclusion: Sarcosine treatment can achieve a fast therapeutic effect in some OCD patients, particularly those who are treatment naive. The study supports the glycine transporter-1 as a novel target for developing new OCD treatment. Large-series placebo-controlled, double-blind studies are recommended. © 2011 Lippincott Williams & Wilkins.
    Relation: Journal of Clinical Psychopharmacology, 31(3), 369-374
    Data Type: article
    DOI link: http://dx.doi.org/10.1097/JCP.0b013e3182189878
    DOI: 10.1097/JCP.0b013e3182189878
    Appears in Collections:[Department of Psychology] Periodical Articles

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