Biol Psychiat：D-环丝氨酸有助治疗创伤后应激障碍

近日，科学家们发现D-环丝氨酸能加强现有的创伤后应激障碍的治疗方法的治疗功效，新的研究报告发表在Biological Psychiatry杂志上。

创伤后应激障碍（PTSD）是最常见的生活事件。创伤后应激障碍的第一线治疗是暴露疗法，就是让病人在一个安全的环境面对他们的恐惧。虽然这是一种有效的治疗，但仍然会出现许多治疗后的症状，因此其成功率并不高。

在努力改进现有的治疗方法的基础上，本周发表在Biological Psychiatry杂志上的一项新研究测试了前期在创伤后应激障碍以及其他焦虑症的动物模型研究上取得的治疗假说。他们探讨是否可以通过使用D-环丝氨酸（DCS）促进神经可塑性即使得大脑回路能更好地重塑，该药物并不直接用于治疗创伤后应激障碍症状。

要对此进行测试，研究人员招募了创伤后应激障碍患者，所有的人接受10周的露疗法。他们被随机分配给予D-环丝氨酸或安慰剂。研究人员对治疗前后的症状严重程度进行评估。

所有患者由于暴露疗法症状有所缓解，不管他们是否使用了DCS还是安慰剂。然而DCS能加强某类患者暴露疗法的效果。这些人有较严重的创伤后应激障碍，在症状得到改善前需较长的治疗有。

最后研究人员下结论称：开展额外的研究工作是必要的，将来需探索这种结合（暴露疗法与D-环丝氨酸）是否可以成为一种有效的创伤后应激障碍症状的治疗手段。（生物谷：Bioon.com）

doi:10.1016/j.biopsych.2012.02.033
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A Randomized Placebo-Controlled Trial of d-Cycloserine to Enhance Exposure Therapy for Posttraumatic Stress Disorder.

de Kleine RA, Hendriks GJ, Kusters WJ, Broekman TG, van Minnen A.

BACKGROUND:

Posttraumatic stress disorder (PTSD) is a complex and debilitating anxiety disorder, and, although prolonged exposure therapy has been proven effective, many patients remain symptomatic after treatment. In other anxiety disorders, the supplementary use of d-cycloserine (DCS), a partial agonist at the glutamatergic N-methyl-D-aspartate receptor, showed promise in enhancing treatment effects. We examined whether augmentation of prolonged exposure therapy for PTSD with DCS enhances treatment efficacy.

METHODS:

In a randomized, double-blind, placebo-controlled trial we administered 50 mg DCS or placebo 1 hour before each exposure session to 67 mixed trauma patients, recruited from regular referrals, with a primary PTSD diagnosis satisfying DSM-IV criteria.

RESULTS:

Although DCS did not enhance overall treatment effects, the participants having received DCS did show a stronger treatment response. Exploratory session-by-session analyses revealed that DCS yielded higher symptom reduction in those participants that had more severe pretreatment PTSD and needed longer treatment.

CONCLUSIONS:

The present study found preliminary support for the augmentation of exposure therapy with DCS, specifically for patients with more severe PTSD needing longer treatment.