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Neurosci Biobehav Rev. 2015 Aug;55:294-321. doi: 10.1016/j.neubiorev.2015.04.015. Epub 2015 May 6.

Clinical trials of N-acetylcysteine in psychiatry and neurology: A systematic review.

Author information

1
Arkansas Children's Hospital, Little Rock, AR, United States; Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, United States. Electronic address: ddeepmala@uams.edu.
2
Arkansas Children's Hospital, Little Rock, AR, United States; Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States.
3
Arkansas Children's Hospital, Little Rock, AR, United States; Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, United States.
4
Florey Institute of Neuroscience and Mental Health, Department of Psychiatry, and Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Parkville, Australia; IMPACT Strategic Research Centre, School of Medicine, Deakin University, Barwon Health, Geelong, Victoria, Australia.
5
BioAdvantex Pharma Inc., MaRS Discovery District, Toronto, ON, Canada.

Abstract

N-acetylcysteine (NAC) is recognized for its role in acetaminophen overdose and as a mucolytic. Over the past decade, there has been growing evidence for the use of NAC in treating psychiatric and neurological disorders, considering its role in attenuating pathophysiological processes associated with these disorders, including oxidative stress, apoptosis, mitochondrial dysfunction, neuroinflammation and glutamate and dopamine dysregulation. In this systematic review we find favorable evidence for the use of NAC in several psychiatric and neurological disorders, particularly autism, Alzheimer's disease, cocaine and cannabis addiction, bipolar disorder, depression, trichotillomania, nail biting, skin picking, obsessive-compulsive disorder, schizophrenia, drug-induced neuropathy and progressive myoclonic epilepsy. Disorders such as anxiety, attention deficit hyperactivity disorder and mild traumatic brain injury have preliminary evidence and require larger confirmatory studies while current evidence does not support the use of NAC in gambling, methamphetamine and nicotine addictions and amyotrophic lateral sclerosis. Overall, NAC treatment appears to be safe and tolerable. Further well designed, larger controlled trials are needed for specific psychiatric and neurological disorders where the evidence is favorable.

KEYWORDS:

Mechanism of action; N-acetylcysteine (NAC); Neurology; Psychiatry

PMID:
25957927
DOI:
10.1016/j.neubiorev.2015.04.015
[Indexed for MEDLINE]
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