Glycine to Treat Psychotic Disorders in Children

The ability of glycine to potentiate the NMDA receptor-complex, along with the fact that it is well tolerated in short-and long-term administration, has raised the possibility that it may provide an effective treatment of augmentation for neuroleptic-resistant negative symptoms of schizophrenia. Up to ten children and adolescents, ages 9-18, meeting DSM-IV criteria for schizophrenia, schizoaffective disorder and psychotic disorder not otherwise specified with onset of psychosis by age 12 who have failed at least two prior antipsychotics entering this protocol on their current antipsychotic medication(s) will participate in an open 8-week trial of adjunctive glycine therapy. In addition to the potential benefits, if glycine therapy ameliorates enduring negative symptoms of schizophrenia, we anticipate that recruiting these rare patients will be facilitated by the availability of this new treatment. This study will provide pilot data regarding the beneficial effects and safety of adjunctive glycine therapy for children and adolescents with treatment refractory psychotic disorders. The availability of newer alternate treatments is also important for recruitment of patients in the broader study of the neurobiology and genetics of very early onset schizophrenia. Children and adolescents ages nine to eighteen will be allowed into the study. Subjects entering the protocol as new patients will be characterized by clinical phenomenology, eye tracking, MRI brain imaging, cerebrospinal fluid, plasma and urinary biochemistry, and chromosomal analysis. Patients with prominent mood symptoms who have required the addition of mood stabilizing agents such as lithium or valproic acid will be allowed to remain on these medications for the duration of the treatment trial, if clinically indicated. Liver chemistries will be checked at baseline and at the end of the study. All first-degree relatives are interviewed in person and undergo eye tracking measurement and contribute blood cell lines as part of a genetic study of the cohort (84-M-0050).