Supplementation of D-cycloserine to intermittent theta-burst transcranial magnetic stimulation therapy helps reduce the severity of depression
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Reviewed by Dat Tien Nguyen, B.A, ScM.
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Posted on October 19th, 2022
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Past studies had reported that transcranial magnetic stimulation, such as with intermittent bursts of theta wave, can be used to treat major depressive disorder. The efficacy of these methods are dependent on synaptic plasticity; thus, supplementation with regulating agents can be beneficial. D-cycloserine is a partial agonist to the N-methyl-D-aspartate (NMDA) receptor on the postsynaptic membrane that regulates synaptic plasticity. A study conducted by researchers and clinicians at the University of Calgary had reported that supplementation with this agent helps with treating depression.
The trial included 50 adults between the age of 18 and 65 years old that had been diagnosed with moderate-to-severe major depressive disorder - with a minimum score of 18 on the Hamilton Depression Rating Scale and a maximum score of 8 on the Young Mania Rating Scale. In combination with noninvasive intermittent theta-burst transcranial magnetic stimulation (iTBS) to the left dorsolateral prefrontal cortex, the patients were randomly assigned to receive either 100 mg of D-cycloserine or placebo. The intervention period lasted for 4 weeks; concurrent usage of treatment/placebo with iTBS happens for the first 2 weeks (10 treatments), and iTBS was performed without supplementation for the last 2 weeks (10 treatments). The Montgomery-Åsberg Depression Rating Scale (MADRS) was used to assess the severity of depression. The study found that supplementation of D-cycloserine to iTBS helps improve the MADRS score by 6.15 points when compared to those who received placebo. This translates to a 6.88 times higher rate of clinical success by the end of the 4-week therapy, and reduces the risk of clinical remission by 14.78 times. In addition, those in the supplementation group reported a slight improvement in overall wellbeing and a minor decrease in anxiety. With regards to safety, those in the D-cycloserine group did not experience any allergic reactions, seizures, or psychotomimetic effects. However, most of them (92%) experience headaches - initially with an average subjective severity rating of 2.9 over 10 - that decrease and resolve over the course of therapy.
The trial included 50 adults between the age of 18 and 65 years old that had been diagnosed with moderate-to-severe major depressive disorder - with a minimum score of 18 on the Hamilton Depression Rating Scale and a maximum score of 8 on the Young Mania Rating Scale. In combination with noninvasive intermittent theta-burst transcranial magnetic stimulation (iTBS) to the left dorsolateral prefrontal cortex, the patients were randomly assigned to receive either 100 mg of D-cycloserine or placebo. The intervention period lasted for 4 weeks; concurrent usage of treatment/placebo with iTBS happens for the first 2 weeks (10 treatments), and iTBS was performed without supplementation for the last 2 weeks (10 treatments). The Montgomery-Åsberg Depression Rating Scale (MADRS) was used to assess the severity of depression. The study found that supplementation of D-cycloserine to iTBS helps improve the MADRS score by 6.15 points when compared to those who received placebo. This translates to a 6.88 times higher rate of clinical success by the end of the 4-week therapy, and reduces the risk of clinical remission by 14.78 times. In addition, those in the supplementation group reported a slight improvement in overall wellbeing and a minor decrease in anxiety. With regards to safety, those in the D-cycloserine group did not experience any allergic reactions, seizures, or psychotomimetic effects. However, most of them (92%) experience headaches - initially with an average subjective severity rating of 2.9 over 10 - that decrease and resolve over the course of therapy.