title: Effects of N-acetylcysteine on substance use in bipolar disorder: a randomised placebo-controlled clinical trial.
abstract: OBJECTIVE
  To evaluate the effect of N-acetylcysteine (NAC) on substance use in a double-blind, placebo-controlled trial of NAC in bipolar disorder. It is hypothesised that NAC will be superior to placebo for reducing scores on the Clinical Global Impressions scale for Substance Use (CGI-SU).
  
  
  METHODS
  Participants were randomised to 6-months of treatment with 2 g/day NAC (n = 38) or placebo (n = 37). Substance use was assessed at baseline using the Habits instrument. Change in substance use was assessed at regular study visits using the CGI-SU.
  
  
  RESULTS
  Amongst the 75 participants 78.7% drank alcohol (any frequency), 45.3% smoked tobacco and 92% consumer caffeine. Other substances were used by fewer than six participants. Caffeine use was significantly lower for NAC-treated participants compared with placebo at week 2 of treatment but not at other study visits.
  
  
  CONCLUSIONS
  NAC appeared to have little effect on substance use in this population. A larger study on a substance using population will be necessary to determine if NAC may be a useful treatment for substance use.
authors.affiliation: 1Department of Clinical and Biomedical Sciences: Barwon Health, The University of Melbourne, Geelong, Australia.
authors.forename: Michelle
authors.initials: M
authors.lastname: Bernardo
authors.affiliation: 1Department of Clinical and Biomedical Sciences: Barwon Health, The University of Melbourne, Geelong, Australia.
authors.forename: Seetal
authors.initials: S
authors.lastname: Dodd
authors.affiliation: 4Laboratório de Psiquiatria Molecular, Centro de Pesquisas, Hospital de Clínicas de Porto Alegre, Brazil.
authors.forename: Clarissa S
authors.initials: CS
authors.lastname: Gama
authors.affiliation: 3Mental Health Research Institute, Parkville, Australia.
authors.forename: David L
authors.initials: DL
authors.lastname: Copolov
authors.affiliation: 1Department of Clinical and Biomedical Sciences: Barwon Health, The University of Melbourne, Geelong, Australia.
authors.forename: Olivia
authors.initials: O
authors.lastname: Dean
authors.affiliation: 1Department of Clinical and Biomedical Sciences: Barwon Health, The University of Melbourne, Geelong, Australia.
authors.forename: Kristy
authors.initials: K
authors.lastname: Kohlmann
authors.affiliation: 3Mental Health Research Institute, Parkville, Australia.
authors.forename: Susan
authors.initials: S
authors.lastname: Jeavons
authors.affiliation: 3Mental Health Research Institute, Parkville, Australia.
authors.forename: Ian
authors.initials: I
authors.lastname: Schapkaitz
authors.affiliation: 3Mental Health Research Institute, Parkville, Australia.
authors.forename: Murray
authors.initials: M
authors.lastname: Anderson-Hunt
authors.affiliation: 3Mental Health Research Institute, Parkville, Australia.
authors.forename: Ashley I
authors.initials: AI
authors.lastname: Bush
authors.affiliation: 1Department of Clinical and Biomedical Sciences: Barwon Health, The University of Melbourne, Geelong, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Berk