Conclusion:
Our results suggest that decreased D-serine availability may justify combining D-serine therapy with antipsychotics in patients with schizophrenia. However, clinical methodological heterogeneity across studies should be considered a major limitation of this analysis.
Source:
SE Cho, KS Na, SJ Cho and SG Kang,
Neuroscience letters , Nov 2016 10
An increasing amount of evidence indicates that d-serine, a potent and selective endogenous coagonist of the N-methyl-d-aspartate receptor (NMDAR), is efficacious in the treatment of schizophrenia. Although the therapeutic efficacy of d-serine supplementation is based on the d-serine deficit and NMDAR hypofunction hypothesis, it has not been confirmed whether d-serine levels are decreased in patients with schizophrenia compared to healthy controls. We searched the following electronic databases: Embase, Ovid Medline, and the Cochrane Library. A total of 20 studies were included in our meta-analysis. Serum d-serine levels were significantly decreased in patients with schizophrenia (standardized mean difference (SMD)=-1.008, 95% CI=-1.827 to -0.190). In the meta-regression analysis, male gender was positively correlated with serum d-serine levels (coefficient=0.190, 95% CI=0.070 to 0.311). d-Serine therapy combined with antipsychotics significantly improved negative (SMD=-0.319, 95% CI=-0.576 to -0.061) and positive (SMD=-0.211, 95% CI=-0.413 to -0.009) symptoms in patients with schizophrenia. Our results suggest that decreased d-serine availability may justify combining d-serine therapy with antipsychotics in patients with schizophrenia. However, clinical methodological heterogeneity across studies should be considered a major limitation of this analysis.
More info:
D-Serine is being studied in rodents as a potential treatment for schizophrenia and L-serine is in a FDA-approved human clinical trial as a possible treatment for Amyotrophic Lateral Sclerosis ALS (ClinicalTrials.gov identifier: NCT01835782). A 2011 meta-analysis found adjunctive sarcosine to have a medium effect size for negative and total symptoms. D-Serine has also been described as a potential biomarker for early Alzheimer's disease (AD) diagnosis, due to a relatively high concent
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