Cycloserine Induced Psychosis, Insomnia and Suicidal Attempts in a Young Female Patient with Pre-Extensively Drug Resistant Tuberculosis
The World Health Organization classifies cycloserine as a group four second line anti tubercular drug for the treatment of drug resistant tuberculosis. Neuropsychiatric adverse drug reactions associated with cycloserine need more attention as they may compromise treatment success. Here, we report a...
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| Format: | Article |
| Language: | English |
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Research Center for Rational Use of Drugs (RCRUD)
2022-12-01
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| Series: | Journal of Pharmaceutical Care |
| Subjects: | |
| Online Access: | https://jpc.tums.ac.ir/index.php/jpc/article/view/535 |
| _version_ | 1797943687469072384 |
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| author | Priyanka Pravinbhai Hotha Shubhima Grover Rachna Gupta |
| author_facet | Priyanka Pravinbhai Hotha Shubhima Grover Rachna Gupta |
| author_sort | Priyanka Pravinbhai Hotha |
| collection | DOAJ |
| description |
The World Health Organization classifies cycloserine as a group four second line anti tubercular drug for the treatment of drug resistant tuberculosis. Neuropsychiatric adverse drug reactions associated with cycloserine need more attention as they may compromise treatment success. Here, we report a case of cycloserine induced psychosis, insomnia and suicidal attempts in a young female patient with pre-extensively drug resistant tuberculosis (pre-XDR-TB). A 20-year-old female patient was prescribed longer oral XDR-TB regimen (high dose of moxifloxacin, cycloserine, linezolid, clofazimine, bedaquiline and pyridoxine). After fifteen days of treatment, patient developed changes in behaviour with frequent episodes of spontaneous and excessive laughing or crying. She also developed insomnia, started to hear voices and made two attempts of suicide. Following this, cycloserine was discontinued. Clonazepam and clomipramine were prescribed to her. Patient gradually recovered over a period of one month. Extreme caution with regular and close monitoring should be exercised while administering cycloserine because psychiatric adverse drug reactions could be associated with increased risk of poor drug adherence in drug resistant tuberculosis.
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| first_indexed | 2024-04-10T20:28:07Z |
| format | Article |
| id | doaj.art-0445c0734adb4a65afe3c33f96b4fe27 |
| institution | Directory Open Access Journal |
| issn | 2322-4630 2322-4509 |
| language | English |
| last_indexed | 2024-04-10T20:28:07Z |
| publishDate | 2022-12-01 |
| publisher | Research Center for Rational Use of Drugs (RCRUD) |
| record_format | Article |
| series | Journal of Pharmaceutical Care |
| spelling | doaj.art-0445c0734adb4a65afe3c33f96b4fe272023-01-25T07:55:22ZengResearch Center for Rational Use of Drugs (RCRUD)Journal of Pharmaceutical Care2322-46302322-45092022-12-0110410.18502/jpc.v10i4.11588Cycloserine Induced Psychosis, Insomnia and Suicidal Attempts in a Young Female Patient with Pre-Extensively Drug Resistant TuberculosisPriyanka Pravinbhai Hotha0Shubhima Grover1Rachna Gupta2Department of Pharmacology, University College of Medical Sciences, Delhi, India.Department of Pharmacology, University College of Medical Sciences, Delhi, India.Department of Pharmacology, University College of Medical Sciences, Delhi, India. The World Health Organization classifies cycloserine as a group four second line anti tubercular drug for the treatment of drug resistant tuberculosis. Neuropsychiatric adverse drug reactions associated with cycloserine need more attention as they may compromise treatment success. Here, we report a case of cycloserine induced psychosis, insomnia and suicidal attempts in a young female patient with pre-extensively drug resistant tuberculosis (pre-XDR-TB). A 20-year-old female patient was prescribed longer oral XDR-TB regimen (high dose of moxifloxacin, cycloserine, linezolid, clofazimine, bedaquiline and pyridoxine). After fifteen days of treatment, patient developed changes in behaviour with frequent episodes of spontaneous and excessive laughing or crying. She also developed insomnia, started to hear voices and made two attempts of suicide. Following this, cycloserine was discontinued. Clonazepam and clomipramine were prescribed to her. Patient gradually recovered over a period of one month. Extreme caution with regular and close monitoring should be exercised while administering cycloserine because psychiatric adverse drug reactions could be associated with increased risk of poor drug adherence in drug resistant tuberculosis. https://jpc.tums.ac.ir/index.php/jpc/article/view/535Adverse Drug Reaction; Cycloserine; Insomnia; Drug Resistant Tuberculosis; Psychosis. |
| spellingShingle | Priyanka Pravinbhai Hotha Shubhima Grover Rachna Gupta Cycloserine Induced Psychosis, Insomnia and Suicidal Attempts in a Young Female Patient with Pre-Extensively Drug Resistant Tuberculosis Journal of Pharmaceutical Care Adverse Drug Reaction; Cycloserine; Insomnia; Drug Resistant Tuberculosis; Psychosis. |
| title | Cycloserine Induced Psychosis, Insomnia and Suicidal Attempts in a Young Female Patient with Pre-Extensively Drug Resistant Tuberculosis |
| title_full | Cycloserine Induced Psychosis, Insomnia and Suicidal Attempts in a Young Female Patient with Pre-Extensively Drug Resistant Tuberculosis |
| title_fullStr | Cycloserine Induced Psychosis, Insomnia and Suicidal Attempts in a Young Female Patient with Pre-Extensively Drug Resistant Tuberculosis |
| title_full_unstemmed | Cycloserine Induced Psychosis, Insomnia and Suicidal Attempts in a Young Female Patient with Pre-Extensively Drug Resistant Tuberculosis |
| title_short | Cycloserine Induced Psychosis, Insomnia and Suicidal Attempts in a Young Female Patient with Pre-Extensively Drug Resistant Tuberculosis |
| title_sort | cycloserine induced psychosis insomnia and suicidal attempts in a young female patient with pre extensively drug resistant tuberculosis |
| topic | Adverse Drug Reaction; Cycloserine; Insomnia; Drug Resistant Tuberculosis; Psychosis. |
| url | https://jpc.tums.ac.ir/index.php/jpc/article/view/535 |
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