title: Clinical trials of N-acetylcysteine in psychiatry and neurology: A systematic review.
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.
authors.affiliation: 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.
authors.lastname: Deepmala
authors.affiliation: Arkansas Children's Hospital, Little Rock, AR, United States; Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States.
authors.forename: John
authors.initials: J
authors.lastname: Slattery
authors.affiliation: Arkansas Children's Hospital, Little Rock, AR, United States; Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, United States.
authors.forename: Nihit
authors.initials: N
authors.lastname: Kumar
authors.affiliation: Arkansas Children's Hospital, Little Rock, AR, United States; Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States.
authors.forename: Leanna
authors.initials: L
authors.lastname: Delhey
authors.affiliation: 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.
authors.forename: Michael
authors.initials: M
authors.lastname: Berk
authors.affiliation: 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.
authors.forename: Olivia
authors.initials: O
authors.lastname: Dean
authors.affiliation: BioAdvantex Pharma Inc., MaRS Discovery District, Toronto, ON, Canada.
authors.forename: Charles
authors.initials: C
authors.lastname: Spielholz
authors.affiliation: Arkansas Children's Hospital, Little Rock, AR, United States; Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States.
authors.forename: Richard
authors.initials: R
authors.lastname: Frye
mesh_terms: D000111:Acetylcysteine / Q000009:adverse effects / Q000627:therapeutic use*; D000293:Adolescent; D000328:Adult; D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy*; D009422:Nervous System Diseases / Q000188:drug therapy*; D009462:Neurology; D011570:Psychiatry; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000111:Acetylcysteine
keywords: Mechanism of action; N-acetylcysteine (NAC); Neurology; Psychiatry