title: N-acetylcysteine for major depressive episodes in bipolar disorder.
abstract: OBJECTIVE
  In this report, we aimed to evaluate the effect of add-on N-acetylcysteine (NAC) on depressive symptoms and functional outcomes in bipolar disorder. To that end, we conducted a secondary analysis of all patients meeting full criteria for a depressive episode in a placebo controlled trial of adjunctive NAC for bipolar disorder.
  
  
  METHODS
  Twenty-four week randomised clinical trial comparing adjunctive NAC and placebo in individuals with bipolar disorder experiencing major depressive episodes. Symptomatic and functional outcome data were collected over the study period.
  
  
  RESULTS
  Seventeen participants were available for this report. Very large effect sizes in favor of NAC were found for depressive symptoms and functional outcomes at endpoint. Eight of the ten participants on NAC had a treatment response at endpoint; the same was true for only one of the seven participants allocated to placebo.
  
  
  CONCLUSIONS
  These results indicate that adjunctive NAC may be useful for major depressive episodes in bipolar disorder. Further studies designed to confirm this hypothesis are necessary.
authors.affiliation: National Institute for Translational Medicine, Hospital de Clínicas de Porto Alegre, Brazil.
authors.forename: Pedro V
authors.initials: PV
authors.lastname: Magalhães
authors.forename: Olívia M
authors.initials: OM
authors.lastname: Dean
authors.forename: Ashley I
authors.initials: AI
authors.lastname: Bush
authors.forename: David L
authors.initials: DL
authors.lastname: Copolov
authors.forename: Gin S
authors.initials: GS
authors.lastname: Malhi
authors.forename: Kristy
authors.initials: K
authors.lastname: Kohlmann
authors.forename: Susan
authors.initials: S
authors.lastname: Jeavons
authors.forename: Ian
authors.initials: I
authors.lastname: Schapkaitz
authors.forename: Murray
authors.initials: M
authors.lastname: Anderson-Hunt
authors.forename: Michael
authors.initials: M
authors.lastname: Berk
mesh_terms: D000111:Acetylcysteine / Q000627:therapeutic use*; D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy*; D017024:Chemotherapy, Adjuvant; D003866:Depressive Disorder / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents; D000111:Acetylcysteine