title: N-acetylcysteine as an adjunct to risperidone for treatment of negative symptoms in patients with chronic schizophrenia: a randomized, double-blind, placebo-controlled study.
abstract: OBJECTIVE
  Despite the burden of negative symptoms on quality of life in schizophrenic patients, no completely effective treatment has been developed to address such symptoms yet. Abnormalities in oxidative stress pathways have been recently demonstrated to be involved in the pathophysiology of schizophrenia, and a growing interest in antioxidant agents is emerging for targeting negative symptoms of schizophrenia. N-Acetylcysteine (NAC) is a potent antioxidant with neuroprotective properties. This study aimed to evaluate the possible effects of NAC as an adjunct to risperidone in treating negative symptoms of schizophrenia.
  
  
  METHODS
  In this randomized, double-blind, placebo-controlled, parallel-group study, 42 patients with chronic schizophrenia and a score of 20 or greater on the negative subscale of positive and negative syndrome scale (PANSS) were enrolled in the active phase of their illness. The participants were equally randomized to receive NAC (up to 2 g/d) or placebo, in addition to risperidone (up to 6 mg/d) for 8 weeks. The participants were rated using PANSS every 2 weeks, and the decrease of PANSS negative subscale score was considered as our primary outcome.
  
  
  RESULTS
  By the study end point, NAC-treated patients showed significantly greater improvement in the PANSS total (P = 0.006) and negative subscale (P < 0.001) scores than that in the placebo group, but this difference was not significant for positive and general psychopathology subscales. There was no significant difference between the 2 groups in the frequency of adverse effects.
  
  
  CONCLUSIONS
  NAC add-on therapy showed to be a safe and effective augmentative strategy for alleviating negative symptoms of schizophrenia.
authors.affiliation: *Psychiatric Research Center, Roozbeh Hospital, Tehran University of Medical Sciences; †Razi Hospital, University of Social Welfare and Rehabilitation Sciences; ‡Department of Medical Genetics, Faculty of Medicine, Tehran University of Medical Sciences, Tehran; §Kurdistan University of Medical Sciences, Sanandaj; and ∥ Department of Psychiatry, Arak University of Medical Sciences, Arak, Iran.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Farokhnia
authors.forename: Anita
authors.initials: A
authors.lastname: Azarkolah
authors.forename: Forod
authors.initials: F
authors.lastname: Adinehfar
authors.forename: Mohammad-Reza
authors.initials: MR
authors.lastname: Khodaie-Ardakani
authors.forename: Seyed-Mohammad-Reza
authors.initials: SM
authors.lastname: Hosseini
authors.forename: Habibeh
authors.initials: H
authors.lastname: Yekehtaz
authors.forename: Mina
authors.initials: M
authors.lastname: Tabrizi
authors.forename: Farzin
authors.initials: F
authors.lastname: Rezaei
authors.forename: Bahman
authors.initials: B
authors.lastname: Salehi
authors.forename: Seyed-Mohammad-Hossein
authors.initials: SM
authors.lastname: Sadeghi
authors.forename: Marzieh
authors.initials: M
authors.lastname: Moghadam
authors.forename: Fardin
authors.initials: F
authors.lastname: Gharibi
authors.forename: Omid
authors.initials: O
authors.lastname: Mirshafiee
authors.forename: Shahin
authors.initials: S
authors.lastname: Akhondzadeh
mesh_terms: D000111:Acetylcysteine / Q000008:administration & dosage*; D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage*; D002908:Chronic Disease; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D016166:Free Radical Scavengers / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D018967:Risperidone / Q000008:administration & dosage*; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents; D016166:Free Radical Scavengers; D018967:Risperidone; D000111:Acetylcysteine