Effects of Sodium Benzoate, a D-Amino Acid Oxidase Inhibitor, on Perceived Stress and Cognitive Function Among Patients With Late-Life Depression: A Randomized, Double-Blind, Sertraline- and Placebo-Controlled Trial.

Abstract

BACKGROUND:

Compared with adults with depression in the general population, elderly depressive patients are prone to poor treatment response, more side effects, and early withdrawal with current antidepressants (which principally modulate monoamines). Whether N-methyl-D-aspartate receptor enhancement can benefit treatment of late-life depression deserves study. This study aims to compare sodium benzoate (a D-amino acid oxidase inhibitor and an indirect N-methyl-D-aspartate receptor enhancer), sertraline (a selective serotonin reuptake inhibitor), and placebo in the treatment of late-life depression.

METHODS:

In this randomized, double-blind trial, 117 patients with major depressive disorder aged 55 years or older received 8-week treatment of 250-1500 mg/d of sodium benzoate, 25-150 mg/d of sertraline, or placebo in 2 medical centers. The primary outcome measures were Hamilton Depression Rating Scale and Perceived Stress Scale scores.

RESULTS:

Three treatments similarly decreased clinicians-rated Hamilton Depression Rating Scale scores. Compared with placebo, sodium benzoate but not sertraline substantially improved Perceived Stress Scale scores and cognitive function. Sertraline, but not benzoate, significantly reduced self-report Geriatric Depression Scale scores. Benzoate and placebo showed similar safety profiles, while sertraline was more likely to raise low-density lipoprotein than benzoate and placebo. Benzoate-treated patients were less likely to drop out than sertraline or placebo recipients.

CONCLUSIONS:

Sertraline can reduce subjective depressive symptoms, while benzoate can decrease perceived stress, improve cognitive function, and enhance treatment adherence in late-life depression patients. The results show promise for D-amino acid oxidase inhibition as a novel approach for perceived stress and cognitive decline among patients with late-life depression.

TRIAL REGISTRATION:

ClinicalTrials.gov Identifier: NCT03414931. Registered January 2016.

• Authors: Chieh-Hsin Lin, Shi-Heng Wang, Hsien-Yuan Lane
• Journal: The international journal of neuropsychopharmacology (Int J Neuropsychopharmacol) Vol. 25 Issue 7 Pg. 545-555 (08 04 2022) ISSN: 1469-5111 [Electronic] England
• PMID: 35023557 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: © The Author(s) 2022. Published by Oxford University Press on behalf of CINP.

Chemical References

• Receptors, N-Methyl-D-Aspartate
• Serotonin Uptake Inhibitors
• Oxidoreductases
• Sodium Benzoate
• Sertraline

Topics

• Aged
• Cognition
• Depressive Disorder, Major (drug therapy)
• Double-Blind Method
• Humans
• Middle Aged
• Oxidoreductases (antagonists & inhibitors)
• Psychiatric Status Rating Scales
• Receptors, N-Methyl-D-Aspartate
• Selective Serotonin Reuptake Inhibitors (therapeutic use)
• Sertraline (therapeutic use)
• Sodium Benzoate (therapeutic use)
• Stress, Psychological
• Treatment Outcome