Cycloserine Induced-Psychosis in a 22-Year Old Male Pharmacy Student: A Case Report
American Journal of Psychiatry and Neuroscience
Volume 4, Issue 1, January 2016, Pages: 1-4
Received: Dec. 24, 2015; Accepted: Jan. 13, 2016; Published: Jan. 31, 2016
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Nkporbu Aborlo Kennedy, Department of Neuropsychiatry, Both University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
Ayodeji Oluwaseun, Department of Neuropsychiatry, Both University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
Alasia Datonye Denis, Department of Internal Medicine, Both University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
Stanley Princewill Chukwuemeka, Department of Neuropsychiatry, Both University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
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This is case of cycloserine induced-psychosis in a 22-year old male patient on treatment for multi-drugs resistant tuberculosis (MDRTB) at the Aluu MDRTB centre of UPTH. Tuberculosis is a chronic respiratory infection caused by mycobacterium tuberculosis. Cycloserine is a Category IV antimycobacterial agent used for the treatment of resistant tuberculosis. The overall clinical scenerio forms this case report. The aim of this report was to highlight a case of cycloserine induced-psychosis in a 22-year old male patient on treatment for drug resistant tuberculosis at the Aluu MDRTB centre of UPTH and to further point to the fact that it is reversible. The case report of the patient was retrieved and reviewed together with relevant literatures. A 22-year old male patient who was diagnosed of tuberculosis in December, 2013 andrediagnosed as multidrug resistant tuberculosis about 6 months ago. He was admitted as a referral into the MDRTBcentre at Aluu5 months following the later and commenced on a course of Category IV anti TB regimen including cycloserine at a dose of 75 Omg dly. There was no history of use of psychoactive substances and no family history of mental illnesses. His body weight as at the time of the report was 47 kg. Routine and other investigations including full blood count with differencials, electrolyte, urea and creatinine and urinalysis, thyroid function test done were all within normal ranges. Retroviral screening test was seronegative. Within 1week of commencing the antituberculosis regimen, patient began to manifest a range of psychotic features unusual abnormal behaviours characterized by irrational talks, seeing of strange images unseen by others in clear conscious. After detailed evaluation and with high index of suspicion, a diagnosis of cycloserine-induced psychosis was entertained. The psychiatrist recommended that the cycloerinebe withheld and patient was commenced on low dose atypical antipsychotic agent. Within 48hours, symptoms began to resolve and within 72 hours there was marked improvement particularly in the psychotic symptoms. A good number of medications like cycloserine have been known to induce psychosis. Clinicians should always apply caution particularly in dosage and assess patients fitness for these group of medications. This will help to prevent precipitation of psychiatric adverse symptoms and guarantee the patient optimal care.
Cycloserine, Psychosis, MDRTB, UPTH
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Nkporbu Aborlo Kennedy, Ayodeji Oluwaseun, Alasia Datonye Denis, Stanley Princewill Chukwuemeka, Cycloserine Induced-Psychosis in a 22-Year Old Male Pharmacy Student: A Case Report, American Journal of Psychiatry and Neuroscience. Vol. 4, No. 1, 2016, pp. 1-4. doi: 10.11648/j.ajpn.20160401.11
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