title: What Future Role Might N-Acetyl-Cysteine Have in the Treatment of Obsessive Compulsive and Grooming Disorders?: A Systematic Review.
abstract: Licensed pharmacological treatments for obsessive-compulsive disorders include selective serotonin reuptake inhibitors and tricyclic antidepressants. However, a large proportion of patients show minimal or no therapeutic response to these treatments. The glutamatergic system has been implicated in the etiology of obsessive-compulsive spectrum disorders, and it has been postulated that n-acetyl-cysteine (NAC) could have a therapeutic effect on these conditions through its actions on the glutamatergic system and the reduction of oxidative stress. A systematic review was conducted on the existing methodologically robust literature regarding the efficacy of NAC on obsessive-compulsive spectrum disorders in adults and children. Four randomized, double-blind placebo-controlled studies were identified, investigating the effects of NAC on obsessive-compulsive disorder, trichotillomania, and onychophagia. Results remain inconclusive, but NAC may still be useful as a treatment for obsessive-compulsive spectrum disorders on an individual level, particularly as the compound has a relatively benign side-effect profile. The dearth of methodologically robust work is clinically important: larger randomized controlled trials are required to inform of any meaningful clinical effectiveness, and to better determine which, if any, clinical populations might most benefit.
authors.affiliation: From the *Institute of Psychiatry, Psychology and Neuroscience, King's College London; †Oxleas NHS Foundation Trust, London; and ‡Division of Psychiatry, University College London, United Kingdom.
authors.forename: Louise
authors.initials: L
authors.lastname: Smith
authors.forename: Derek K
authors.initials: DK
authors.lastname: Tracy
authors.forename: Giovanni
authors.initials: G
authors.lastname: Giaroli
mesh_terms: D000111:Acetylcysteine / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D000328:Adult; D002648:Child; D016166:Free Radical Scavengers / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D009771:Obsessive-Compulsive Disorder / Q000188:drug therapy* / Q000503:physiopathology; D018384:Oxidative Stress / Q000187:drug effects; D016032:Randomized Controlled Trials as Topic
chemical_list: D016166:Free Radical Scavengers; D000111:Acetylcysteine