D-cycloserine May Help in Treatment-Resistant Depressive disorder

D-cycloserine May Help in Treatment-Resistant Depressive disorder

NEW YORK CITY—Early evidence suggests the hetiquez drug D-cycloserine may simplicity treatment-resistant depression and supports further trials on the efficacy as a story antidepressant, says a research review scheduled to be presented at the American Psychiatric Association’s twelve-monthly conference.

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

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

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

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

“D-cycloserine is a cost-effective book treatment whose antidepressant properties need larger trials to boost the cumulative evidence on its efficacy as an independent drug or an adjuvant, ” the scientists wrote.

For many depression patients treatment changes are required, including switching to another antidepressant and addition of a second antidepressant or a non-antidepressant real estate agent ("augmentation"). The need to modify treatment is usually necessary because of incomplete or no response to first-line monotherapy or the failure to obtain remission although treatment response (improvement) has been obtained. These caveats of presently available antidepressant drugs highlight the need for innovative pharmacological treatment strategies. Recent data claim that N-methyl-D-aspartate receptor (NMDAR) antagonists and partial agonists at the NMDAR-associated glycine binding site may represent a novel type of antidepressant medications. These types of compounds protect vulnerable neurons against a variety of insults, including stress-induced harm, and may serve to boost and maintain normal synaptic connectivity. In animal models, these compounds mimic the effects of clinically effective antidepressants. Furthermore, down-regulation of the glycine site of the NMDAR was found as a common feature of currently used antidepressant medications. D-cycloserine (DCS, Seromycin) is a diverse spectrum antibiotic, in use over thirty years against tuberculosis, that functions as a partial agonist at the NMDAR-associated glycine site. Beneficial antidepressant results have been reported with 500-1000 mg/day DCS sessions in depressed tuberculosis patients and up to date preliminary findings suggest that DCS may also be beneficial in the treating major depressive disorder. The particular antidepressant effects of DCS seem to reflect effects from the capacity to reduce NMDAR receptor function. Inside the present project, it is proposed to evaluate, by using a random assignment, parallel-group, double blind, placebo handled design, the effects of a NMDAR -antagonist DCS dose regimen, 250 -->  1000 mg/day for 6 wks, as adjuvant pharmacotherapy for treatment-resistant major depressive disorder patients. Typically the study methodology includes the assessment of DCS effects after symptoms profile, neurocognitive tests performance, amino acids serum levels, and brain electrophysiology parameters associated with the prepulse inhibition-startle reply paradigm. It is hypothesized that important beneficial DCS treatment effects will be registered.