The Kingsley Clinic

D-Cycloserine: Uses, Dosage, Side Effects & Interactions

Summary of Key Points

D-cycloserine is a prescription medication used to treat a range of conditions, including tuberculosis (TB) and certain mental health disorders such as anxiety and obsessive-compulsive disorder (OCD). This medication works by influencing neurotransmitters in the brain and disrupting bacterial cell walls. It is essential to take this medication only under the guidance of a healthcare provider. Always adhere to your doctor’s instructions and consult them before making any changes to your dosage or treatment plan.

Names of the Medication

US Brand Name: Seromycin

Generic Name: D-cycloserine

The generic name refers to the active ingredient in the medication, while the brand name is assigned by the manufacturer. For clarity, the generic name will be used in parentheses throughout this article.

Pharmacologic Category

Categories:

  1. Antibiotic, Antitubercular
  2. NMDA Receptor Partial Agonist

Dosing Guidelines for D-cycloserine

The appropriate dosage of D-cycloserine depends on the condition being treated. Always follow your healthcare provider’s recommendations and consult them before making any adjustments to your dose. For tailored advice, consider scheduling a consultation with a qualified medical professional.

D-cycloserine for Tuberculosis (TB)

Adult Dose: 250 mg to 500 mg per day, divided into two doses.

Frequency: Twice daily.

Length of Treatment: Typically 6 to 12 months, depending on the severity of the infection and the patient’s response to treatment.

D-cycloserine for Anxiety Disorders

Adult Dose: 50 mg to 500 mg per day, depending on the severity of symptoms and individual response to treatment.

Frequency: Once daily or divided into two doses.

Length of Treatment: Varies based on individual progress and clinical guidelines.

D-cycloserine for Obsessive-Compulsive Disorder (OCD)

Adult Dose: 50 mg to 100 mg per day.

Frequency: Once daily or divided into two doses.

Length of Treatment: Typically used in combination with cognitive-behavioral therapy (CBT) for several weeks or months.

D-cycloserine for Social Anxiety Disorder

Adult Dose: 50 mg to 100 mg per day.

Frequency: Once daily or divided into two doses.

Length of Treatment: Varies based on individual response and clinical recommendations.

D-cycloserine for Post-Traumatic Stress Disorder (PTSD)

Adult Dose: 50 mg to 100 mg per day.

Frequency: Once daily or divided into two doses.

Length of Treatment: Varies depending on individual response and treatment guidelines.

D-cycloserine for Schizophrenia

Adult Dose: 50 mg to 100 mg per day.

Frequency: Once daily or divided into two doses.

Length of Treatment: Determined by individual response and clinical recommendations.

D-cycloserine for Panic Disorder

Adult Dose: 50 mg to 100 mg per day.

Frequency: Once daily or divided into two doses.

Length of Treatment: Tailored to the individual’s response and clinical guidelines.

D-cycloserine for Phobias

Adult Dose: 50 mg to 100 mg per day.

Frequency: Once daily or divided into two doses.

Length of Treatment: Adjusted based on individual progress and clinical recommendations.

D-cycloserine for Depression

Adult Dose: 50 mg to 100 mg per day.

Frequency: Once daily or divided into two doses.

Length of Treatment: Varies depending on individual response and clinical guidelines.

D-cycloserine for Substance Use Disorders

Adult Dose: 50 mg to 100 mg per day.

Frequency: Once daily or divided into two doses.

Length of Treatment: Determined by individual response and clinical recommendations.

Dosage Forms and Strengths

Available Form: Capsule

Strength: 250 mg

Administration Instructions for D-cycloserine

D-cycloserine should be taken exactly as prescribed by your healthcare provider. It is typically administered orally, with or without food. If you experience stomach discomfort, taking it with food may help alleviate symptoms. To ensure consistent levels of the medication in your bloodstream, take it at the same time each day. Do not discontinue D-cycloserine without consulting your doctor, as stopping abruptly could worsen your condition.

Contraindications

A contraindication refers to a specific condition or situation in which using a particular medication could be harmful. Before starting D-cycloserine, it is essential to share your complete medical history and current medications with your healthcare provider. This ensures the medication is safe and appropriate for your individual needs.

Contraindications for D-cycloserine

Severe kidney disease:D-cycloserine is primarily eliminated from the body through the kidneys. If kidney function is significantly impaired, the medication can build up in the body, potentially leading to toxic effects.

History of seizures:D-cycloserine may increase the risk of seizures, particularly in individuals with epilepsy or other seizure disorders. This risk should be carefully evaluated before starting treatment.

Alcoholism or chronic alcohol use: Consuming alcohol while taking D-cycloserine can heighten the likelihood of side effects such as seizures and confusion. Avoiding alcohol is strongly recommended during treatment.

Severe mental health conditions:D-cycloserine may worsen symptoms of severe depression, anxiety, or psychosis. If you have a history of mental health challenges, it is crucial to discuss this with your healthcare provider before beginning the medication.

Drug-to-Drug Interactions

Certain medications can interact with D-cycloserine, potentially increasing side effects or reducing the effectiveness of one or both drugs. To minimize risks, inform your healthcare provider about all medications you are currently taking, including prescription drugs, over-the-counter medications, supplements, and herbal products.

Medications That May Interact with D-cycloserine

Alcohol: Combining alcohol with D-cycloserine can significantly raise the risk of seizures and nervous system side effects, such as dizziness and confusion.

Isoniazid (Nydrazid): This tuberculosis antibiotic, when taken with D-cycloserine, may increase the likelihood of neurotoxic effects, including seizures and mental confusion.

Phenytoin (Dilantin): This anti-seizure medication may intensify side effects when used alongside D-cycloserine, particularly in individuals with a history of seizures.

Antidepressants (e.g., Fluoxetine [Prozac], Sertraline [Zoloft]):D-cycloserine may interact with certain antidepressants, potentially worsening symptoms of anxiety or depression.

D-cycloserine in Pregnancy

Is it safe to take D-cycloserine during pregnancy?

The safety of D-cycloserine during pregnancy has not been fully established. While animal studies suggest potential risks to the fetus, data on human pregnancies is limited. If you are pregnant or planning to become pregnant, it is important to discuss the potential risks and benefits of D-cycloserine with your healthcare provider. They will help you weigh the risks of untreated tuberculosis or other conditions against the possible effects on your baby.

D-cycloserine While Breastfeeding

Is it safe to take D-cycloserine while breastfeeding?

There is limited information on whether D-cycloserine passes into breast milk. Due to the potential for serious side effects in a nursing infant, breastfeeding is generally not recommended while taking D-cycloserine. If you are breastfeeding or planning to breastfeed, consult your healthcare provider to explore alternative treatments or feeding options.

Estimated Cost of Medication

The cost of a 30-day supply of D-cycloserine without insurance typically ranges from $1,200 to $1,500 when using a GoodRx coupon. Prices may vary depending on the pharmacy and location. To find the best price, check with your pharmacy or use a coupon service like GoodRx.

Possible Alternatives

If D-cycloserine is not suitable for you, there are alternative treatments and lifestyle changes that may help manage your condition. Always consult your healthcare provider before making any changes to your treatment plan. You can also schedule a telemedicine appointment with one of our providers to discuss your options.

Tuberculosis

Isoniazid (Nydrazid): A commonly prescribed first-line treatment for tuberculosis.

Rifampin (Rifadin): Another first-line medication used to treat tuberculosis.

Lifestyle changes: Maintaining proper nutrition and getting adequate rest can support your immune system during treatment.

Anxiety Disorders

Cognitive Behavioral Therapy (CBT): A structured form of talk therapy that helps manage anxiety by addressing and altering negative thought patterns.

Selective Serotonin Reuptake Inhibitors (SSRIs): Medications such as Fluoxetine (Prozac) or Sertraline (Zoloft) are commonly prescribed to treat anxiety disorders.

Lifestyle changes: Regular physical activity, mindfulness practices, and stress management techniques can help alleviate anxiety symptoms.

Obsessive-Compulsive Disorder (OCD)

SSRIs: Medications like Fluoxetine (Prozac) or Sertraline (Zoloft) are often used to manage OCD symptoms.

Exposure and Response Prevention (ERP): A specialized therapy that helps patients confront fears and reduce compulsive behaviors.

Social Anxiety Disorder

CBT: Therapy focused on identifying and changing negative thought patterns to manage social anxiety.

SSRIs: Medications such as Sertraline (Zoloft) or Paroxetine (Paxil) may help reduce symptoms of social anxiety.

Post-Traumatic Stress Disorder (PTSD)

Trauma-focused CBT: A therapy designed to help individuals process traumatic experiences and reduce PTSD symptoms.

SSRIs: Medications like Sertraline (Zoloft) or Paroxetine (Paxil) are commonly prescribed for PTSD.

Schizophrenia

Antipsychotic medications: Drugs such as Risperidone (Risperdal) or Olanzapine (Zyprexa) are used to manage symptoms of schizophrenia.

Psychosocial therapy: Therapy aimed at improving daily functioning and helping patients manage symptoms effectively.

Panic Disorder

CBT: Therapy that helps individuals manage panic attacks by addressing and altering thought patterns.

SSRIs: Medications like Fluoxetine (Prozac) or Sertraline (Zoloft) may help reduce the frequency and severity of panic attacks.

Phobias

Exposure therapy: Gradual exposure to feared situations or objects in a controlled environment to reduce phobia-related anxiety.

CBT: Therapy that helps individuals manage phobias by addressing and changing negative thought patterns.

Depression

SSRIs: Medications such as Fluoxetine (Prozac) or Sertraline (Zoloft) are commonly prescribed to treat depression.

CBT: Therapy that helps individuals manage depression by addressing negative thought patterns and behaviors.

Lifestyle changes: Regular exercise, a balanced diet, and sufficient sleep can improve mood and reduce symptoms of depression.

Substance Use Disorders

Counseling and behavioral therapies: Therapy that helps individuals identify triggers and develop strategies to avoid substance use.

Medications: Drugs like Naltrexone (Vivitrol) or Buprenorphine (Suboxone) may help reduce cravings and manage withdrawal symptoms.

Recent Updates on D-cycloserine Research

Recent studies have been investigating the potential of D-cycloserine as a treatment for various mental health conditions, including anxiety disorders, post-traumatic stress disorder (PTSD), and phobias. Researchers are particularly focused on whether D-cycloserine can enhance the effectiveness of exposure therapy, a well-established approach for managing anxiety and phobias. Preliminary findings suggest that incorporating D-cycloserine into therapy sessions may help reduce fear responses, potentially improving overall treatment outcomes.

While these early results are promising, more research is needed to fully understand the long-term safety and effectiveness of D-cycloserine in mental health care. This includes identifying the most effective D-cycloserine dosage, evaluating potential D-cycloserine side effects, and exploring any D-cycloserine interactions with other medications or therapeutic methods. Such studies are crucial to ensure that this treatment option is both safe and beneficial for a wide range of patients.

If you are considering D-cycloserine as part of your treatment for anxiety, PTSD, or related conditions, it is essential to consult a healthcare provider. Our telemedicine team is available to discuss the latest research on D-cycloserine uses and work with you to create a personalized treatment plan that aligns with your unique needs and goals.

James Kingsley
James Kingsley

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