Journal: Transcranial Magnetic Stimulation 5 (2025) 100185
Authors: Cloutier A; Sullivan S; Kumar S; Brown, J
Background:
Promising clinical benefits were observed with d-cycloserine (DCS) augmentation of intermittent theta-burst stimulation (iTBS), presumably by enhancing long-term potentiation (LTP) through NMDA receptor agonism (Cole et al., 2022). However, the applicability of this trial and accessibility of this approach are unknown.
Ojective: N/A
Methods: N/A
Results:
We report the case of a 28-year-old woman whose psychiatric symptoms worsened during an initial course of 18-Hz rTMS using an H1-coil, and culminated in a suicide attempt and hospitalization. Upon discharge, she underwent a second course of rTMS augmented this time with DCS, and quickly experienced full remission of her suicidal thoughts and marked improvement in her symptoms of depression.
Conclusions:
This is the first real-world report of rTMS using the FDA-approved 250 mg dose of DCS without pharmaceutical compounding, employing a different coil and stimulation protocol than those used in prior clinical trials. This encounter suggests that this augmentation approach may be more broadly applicable than the dose and protocol used in previous trials, and could be a solution for TMS non-responders or for severe and suicidal patients.
