We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Editorial |

Bitopertin The Good News and Bad News

Donald C. Goff, MD1
[+] Author Affiliations
1New York Langone Medical Center, Nathan Kline Institute for Psychiatric Research, Orangeburg, New York
JAMA Psychiatry. 2014;71(6):621-622. doi:10.1001/jamapsychiatry.2014.257.
Text Size: A A A
Published online


In this issue, Umbricht and colleagues1 reported improvement of negative symptoms of schizophrenia associated with 2 of 3 doses of the glycine transporter type 1 inhibitor bitopertin (RG1678) in a phase 2 placebo-controlled, 8-week add-on trial. Although the therapeutic effect was only modest, this is very welcome news because the path to drug development in schizophrenia has been littered with disappointments. The example of clozapine, which was synthesized in 1958 and received Food and Drug Administration approval in 1989, provided impetus to develop similarly effective new compounds. Since then, a series of preclinical and clinical studies by Paul Janssen, MD, pioneered the addition of 5-hydroxytryptamine type 2A antagonism to D2 antagonism, which launched risperidone, the first of the newer-generation antipsychotics, and refinement of dopamine D2 receptor partial agonism led to aripiprazole. Both developments achieved a reduction in neurologic adverse effects, but the promise of clozapine has yet to be realized. Other approaches that followed from discoveries in neuroscience have failed or have yet to reach clinical validation. Bitopertin represents the culmination of more than 2 decades of basic and clinical research on the glutamatergic model of schizophrenia.2



Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

1 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
PubMed Articles