Hypomania after augmenting venlafaxine and olanzapine with sarcosine in a patient with schizophrenia: a case study.
- Authors
- Strzelecki, Dominik; Szyburska, Justyna; Kotlicka-Antczak, Magdalena; Kałużyńska, Olga
- Year
- 2015
- Journal
- Neuropsychiatric disease and treatment
- PMID
- 25784808
- DOI
- 10.2147/NDT.S75734
- PMCID
- PMC4356443
Glutamate is the main excitatory neurotransmitter in the central nervous system. Dysfunction of the glutamatergic system plays an important and well-established role in the pathogenesis of schizophrenia. Agents with glutamatergic properties such as N-methyl-D-aspartate receptor coagonists (ie, glycine, D-cycloserine) and glycine transporter type 1 inhibitors (eg, sarcosine, bitopertin) are investigated in schizophrenia with special focus on negative and cognitive symptomatology. In this article, we describe a case of a 34-year-old woman with diagnosis of schizophrenia with persistent moderate negative and cognitive symptoms, a participant of the Polish Sarcosine Study (PULSAR) treated with olanzapine (25 mg per day) and venlafaxine (75 mg per day). During ten weeks of sarcosine administration (2 g per day) the patient's activity and mood improved, but in the following 2 weeks, the patient reported decreased need for sleep, elevated mood, libido and general activity. We diagnosed drug-induced hypomania and recommended decreasing the daily dose of venlafaxine to 37.5 mg per day, which resulted in normalization of mood and activity in about 1 week. After this change, activity and mood remained stable and better than before adding sarcosine, and subsequent depressive symptoms were not noted. We describe here the second case report where sarcosine induced important affect changes when added to antidepressive and antipsychotic treatment, which supports the hypothesis of clinically important glutamate-serotonin interaction.
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| Name | Type |
|---|---|
| activity | phenotype |
| addiction | phenotype |
| affective symptomatology local | phenotype |
| Affective symptomatology local | phenotype |
| affective symptoms | phenotype |
| ALX-5407 local | drug |
| Alzheimer’s disease | phenotype |
| antidepressants | drug |
| Antidepressive effects local | phenotype |
| antipsychotics | drug |
| anxiety | phenotype |
| attention | phenotype |
| attention problems | phenotype |
| auditory hallucinations | phenotype |
| bitopertin | drug |
| cognition | phenotype |
| Cognitive problems local | phenotype |
| cognitive symptomatology local | phenotype |
| cognitive symptoms | phenotype |
| concentration | phenotype |
| D-cycloserine | drug |
| delusions | phenotype |
| Delusions of reference local | phenotype |
| depressive symptoms | phenotype |
| disorganization | phenotype |
| Drive local | phenotype |
| d-serine | drug |
| excitation | phenotype |
| glutamate | drug |
| Glutamatergic substances local | drug |
| glycine | drug |
| GlyT-1 local | drug |
| hippocampus | anatomy |
| hypomania | phenotype |
| Hypomanic episodes local | phenotype |
| hypomanic state local | phenotype |
| Hypomanic symptoms local | phenotype |
| irritability | phenotype |
| ketamine | drug |
| Libido local | phenotype |
| mania | phenotype |
| Manic episode | phenotype |
| memantine | drug |
| memory | phenotype |
| Memory difficulties local | phenotype |
| mood disorders | phenotype |
| Mood elation local | phenotype |
| NCT01503359 local | cohort |
| negative symptomatology local | phenotype |
| negative symptoms | phenotype |
| neuroleptic local | drug |
| NMDA receptor | drug |
| Paranoid syndrome local | phenotype |
| Polish Sarcosine Study local | cohort |
| prefrontal lobes local | anatomy |
| PULSAR study local | cohort |
| RG1678 | drug |
| sarcosine | drug |
| schizophrenia | phenotype |
| Secondary depressive episode local | phenotype |
| selective serotonin reuptake inhibitors | drug |
| serotonergic substances local | drug |
| serotonin | drug |
| Serotoninergic substances local | drug |
| sleep | phenotype |
| study cohort | cohort |
| Talkativity local | phenotype |
| venlafaxine local | drug |
| Venlafaxine local | drug |
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| Serum levels of interleukin 6 in schizophrenic patients during treatment augmentation with sarcosine (results of the PULSAR study). | Strzelecki D et al. | — | 2018 | → |