Will taking cycloserine cause psychosis?

Cycloserine (Cycloserine) is a second-line anti-tuberculosis drug commonly used to treat multidrug-resistant tuberculosis. It is widely used because of its unique antibacterial mechanism and clinical efficacy. However, a series of central nervous system adverse reactions may occur when taking cycloserine, among which mental disorders are one of the more prominent problems that require special attention. Cycloserine can penetrate the blood-brain barrier and directly act on the central nervous system, causing neuropsychiatric symptoms. This is mainly related to its inhibition of neurotransmitter synthesis and its influence on nerve conduction.

The manifestations of mental disorders are diverse, ranging from headaches, dizziness, inattention, insomnia, anxiety and mood swings to hallucinations, delusions, psychotic symptoms and even epileptic seizures. Studies have shown that cycloserine affects the function of gamma-aminobutyric acid (GABA) receptors, reducing inhibitory nerve conduction in the central nervous system, thereby triggering an increase in nerve excitability, which is considered to be one of the main mechanisms leading to psychiatric symptoms. In addition, the direct toxic effects of cycloserine metabolites on brain tissue may also aggravate neuropsychiatric symptoms. The occurrence of mental disorders is closely related to drug dosage, treatment time and individual differences among patients. Patients with higher doses and prolonged use are more likely to develop severe mental symptoms.

In clinical practice, in order to reduce the risk of mental disorders, doctors usually develop individualized medication plans based on the patient's weight, severity of illness, and drug metabolism, and closely monitor the patient's mental status. Once psychiatric symptoms occur, medical staff will consider adjusting the dosage of the medication or temporarily discontinuing the medication, and provide symptomatic treatment, such as using anti-anxiety drugs, sedatives or antipsychotics as auxiliary treatment. In addition, patients and their families should be informed to be alert to early signs of mental symptoms and report them to doctors promptly for early intervention and treatment to avoid worsening of the condition. Overseas clinical guidelines and studies have emphasized that the prevention and monitoring of psychiatric symptoms are important aspects of cycloserine treatment.

Reference materials:https://en.wikipedia.org/wiki/Cycloserine