Persistent Psychosis Occurring in a Patient Receiving Cycloserine for the Treatment of Multidrug Resistant Tuberculosis

Abstract

A case of cycloserineinduced psychosis persisting after discontinuation of the drug in the treatment of  multidrug resistant tuberculosis in a 26 year old male who was been managed in the hospital for multidrug resistant tuberculosis on daily doses of Cycloserine 500mg, Pyrazinamide 1.2g, Proteonamide 500mg, Kanamy c in 750mg, Levofloxacin 750mg and Vitamin B6 200mg. At the 6th month of treatment, he developed delusional and hallucinatory experiences which subsided with the use of antipsychotics. However, antipsychotic use was not sustained leading to exacerbation of psychotic symptoms and complete abandonment of all his  anti-tubercular medications including cycloserine. Psychiatric symptoms then  progressed into florid psychosis without psychiatric treatment. In conclusion, the case report highlights the enduring psychiatric problems and its consequences that could be associated with the use of cycloserine in the treatment of tuberculosis and the need to integrate effective mental health liaison services for multidrug resistant tuberculosis treatment.