D-cycloserine May Help in Treatment-Resistant Depression

NEW YORK CITY—Early evidence suggests the tuberculosis drug D-cycloserine may ease treatment-resistant depression and supports further trials on its efficacy as a novel antidepressant, says a research review scheduled to be presented at the American Psychiatric Association’s annual meeting.

Navjot Kaur Brainch, MBBS, and coauthor Sanya Virani, MD, MPH, summarized findings from 4 double-blind trials and 2 open-label studies that spanned a total of 84 patients who had received D-cycloserine.

Although 2 studies that paired 100 mg or 250 mg of daily D-cycloserine with transcranial direct magnetic stimulation failed to show any significant improvement in depression scores, studies involving higher doses of daily D-cycloserine did, the researchers found.

Practice Tools: Hamilton Depression Rating Scale (HAM-D)

A study that added D-cycloserine, titrated to 1000 mg daily, to transcranial direct magnetic stimulation showed a significant drop in depressive symptoms in the majority of participants. Another trial that followed administration of intravenous ketamine with 8 weeks of treatment with pyridoxine—a form of vitamin B6—and 1000 mg daily of D-cycloserine demonstrated a 60% remission rate among 7 participants.

Other trials showed symptom improvement in patients with obsessive compulsive disorder and depression after taking D-cycloserine, researchers reported.

“D-cycloserine is a cost-effective novel therapy whose antidepressant properties need larger trials to add to the cumulative evidence on its efficacy as an independent drug or an adjuvant,” the researchers wrote.

—Jolynn Tumolo

Reference

“D-cycloserine: a novel antidepressant to be explored?” Abstract presented at: the American Psychiatric Association Annual Meeting; May 6, 2018; New York, NY.