Neuropsychiatric adverse events associated with cycloserine therapy for multidrug resistant pulmonary tuberculosis
10.3760/cma.j.issn.1674-2397.2014.03.009
- VernacularTitle:含环丝氨酸方案治疗耐多药肺结核引起精神神经等不良反应观察
- Author:
Yumei FAN
;
Fujian LI
;
Limin WU
- Publication Type:Journal Article
- Keywords:
Tuberculosis,pulmonary;
Antitubercular agents;
Cycloserine;
Adverse effects
- From:
Chinese Journal of Clinical Infectious Diseases
2014;7(3):230-234
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate neuropsychiatric adverse effects of cycloserine therapy for multidrug resistant pulmonary tuberculosis (MDR-TB).Methods A total of 82 patients with MDR-TB who were enrolled in Global Fund Round Five MDR-TB Control Program were admitted in Center for Diagnosis and Treatment of Tuberculosis,Hangzhou Red Cross Hospital from May to December 2012.All patients received the standard treatment containing cycloserine for MDR-TB.The adverse reactions during the treatment were recorded,and symptom checklist-90 (SCL-90) scores at different time points were compared with t test.Results Adverse reactions were observed in 66 patients (66/82,80.5％) within 3 months after the initial treatment.Common adverse reactions included arthralgia (42.7％),gastrointestinal reactions (40.2％),central nervous system symptoms (22.0％) and electrolytes disturbance (17.1％).Nine patients had severe neuropsychiatric symptoms characterized by convulsions,depression,anxiety,schizophrenia and attempting suicide,6 of whom had used fluoroquinolones before the study.The above symptoms were relieved after stopping cycloserine or antitubercular agents,and cycloserine was replaced in the following treatment.The total SCL-90 score,depression and anxiety scores were significantly higher during onset of symptoms than those one month after the following treatment (t =2.241,2.301 and 5.659,P ＜ 0.05).Conclusion Cycloserine may induce severe neuropsychiatric adverse reactions in patients receiving standard treatment for MDR-TB.
