title: A preliminary investigation on the efficacy of N-acetyl cysteine for mania or hypomania.
abstract: OBJECTIVE
  Oxidative imbalance has emerged as a treatment target in bipolar disorder. As very limited data are available on the clinical use of antioxidants for mania, we report here results from a post hoc and exploratory subgroup analysis of a randomized, placebo-controlled trial of N-acetyl cysteine (NAC).
  
  
  METHODS
  This was a placebo-controlled, randomized, clinical trial assessing the effect of NAC over 24 weeks in mania or hypomania. Symptomatic and functional outcomes were collected over the study period.
  
  
  RESULTS
  Fifteen participants were available for this report; two participants in each group failed to complete all assessments. Within-group analyses pointed to an improvement in the NAC group on manic symptoms and worsening in the placebo group on depressive symptoms at endpoint.
  
  
  CONCLUSIONS
  Although the sample size was small, these results indicated within-group efficacy for this glutathione precursor as compared to placebo. Future trials specifically designed to demonstrate the efficacy of NAC in mania are needed.
authors.affiliation: National Institute for Translational Medicine, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
authors.forename: Pedro Vieira da Silva
authors.initials: PV
authors.lastname: Magalhães
authors.forename: Olivia 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; D000975:Antioxidants / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales
chemical_list: D000975:Antioxidants; D000111:Acetylcysteine
keywords: Bipolar disorder; N-acetyl cysteine; depression; mania; oxidative stress; remission; treatment