The Role of D-Serine and D-Aspartate in the Pathogenesis and Therapy of Treatment-Resistant Schizophrenia

Nutrients. 2022 Dec 2;14(23):5142. doi: 10.3390/nu14235142.

Abstract

Schizophrenia (Sch) is a severe and widespread mental disorder. Antipsychotics (APs) of the first and new generations as the first-line treatment of Sch are not effective in about a third of cases and are also unable to treat negative symptoms and cognitive deficits of schizophrenics. This explains the search for new therapeutic strategies for a disease-modifying therapy for treatment-resistant Sch (TRS). Biological compounds are of great interest to researchers and clinicians, among which D-Serine (D-Ser) and D-Aspartate (D-Asp) are among the promising ones. The Sch glutamate theory suggests that neurotransmission dysfunction caused by glutamate N-methyl-D-aspartate receptors (NMDARs) may represent a primary deficiency in this mental disorder and play an important role in the development of TRS. D-Ser and D-Asp are direct NMDAR agonists and may be involved in modulating the functional activity of dopaminergic neurons. This narrative review demonstrates both the biological role of D-Ser and D-Asp in the normal functioning of the central nervous system (CNS) and in the pathogenesis of Sch and TRS. Particular attention is paid to D-Ser and D-Asp as promising components of a nutritive disease-modifying therapy for TRS.

Keywords: D-aspartate; D-serine; disease-modifying therapy; treatment-resistant schizophrenia.

Publication types

  • Review

MeSH terms

  • Aspartic Acid*
  • D-Aspartic Acid
  • Glutamic Acid
  • Humans
  • Receptors, N-Methyl-D-Aspartate
  • Schizophrenia* / drug therapy
  • Schizophrenia* / pathology
  • Schizophrenia, Treatment-Resistant
  • Serine

Substances

  • Aspartic Acid
  • D-Aspartic Acid
  • Glutamic Acid
  • Receptors, N-Methyl-D-Aspartate
  • Serine

Grants and funding

This research received no external funding.