title: N-acetylcysteine in the treatment of psychiatric disorders: current status and future prospects.
abstract: N-acetylcysteine (NAC) is widely known for its role as a mucolytic and as an antidote to paracetamol overdose. There is increasing interest in the use of NAC in the treatment of several psychiatric disorders. The rationale for the administration of NAC in psychiatric conditions is based on its role as a precursor to the antioxidant glutathione, and its action as a modulating agent of glutamatergic, dopaminergic, neurotropic and inflammatory pathways. Areas covered: This study reviews the available data regarding the use of NAC in different psychiatric disorders including substance use disorders, autism, obsessive-compulsive spectrum disorders, schizophrenia, depression, bipolar disorder. Promising results were found in trials testing the use of NAC, mainly as an add-on treatment, in cannabis use disorder in young people, depression in bipolar disorder, negative symptoms in schizophrenia, and excoriation (skin-picking) disorder. Despite initial optimism, recent findings regarding NAC efficacy in autism have been disappointing. Expert opinion: These preliminary positive results require further confirmation in larger samples and with longer follow-ups. Given its high tolerability and wide availability, NAC represents an important target to investigate in the field of new adjunctive treatments for psychiatric conditions.
authors: a Department of Diagnostic-Clinical Medicine and Public Health , University of Modena and Reggio Emilia , Modena , Italy.
authors: Alessandro
authors: A
authors: Minarini
authors: a Department of Diagnostic-Clinical Medicine and Public Health , University of Modena and Reggio Emilia , Modena , Italy.
authors: Silvia
authors: S
authors: Ferrari
authors: a Department of Diagnostic-Clinical Medicine and Public Health , University of Modena and Reggio Emilia , Modena , Italy.
authors: Martina
authors: M
authors: Galletti
authors: a Department of Diagnostic-Clinical Medicine and Public Health , University of Modena and Reggio Emilia , Modena , Italy.
authors: Nina
authors: N
authors: Giambalvo
authors: a Department of Diagnostic-Clinical Medicine and Public Health , University of Modena and Reggio Emilia , Modena , Italy.
authors: Daniela
authors: D
authors: Perrone
authors: a Department of Diagnostic-Clinical Medicine and Public Health , University of Modena and Reggio Emilia , Modena , Italy.
authors: Giulia
authors: G
authors: Rioli
authors: a Department of Diagnostic-Clinical Medicine and Public Health , University of Modena and Reggio Emilia , Modena , Italy.
authors: Gian Maria
authors: GM
authors: Galeazzi
mesh_terms: D000111:Acetylcysteine / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D000818:Animals; D000975:Antioxidants / Q000378:metabolism; D016166:Free Radical Scavengers / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D005978:Glutathione / Q000378:metabolism; D006801:Humans; D001523:Mental Disorders / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D000975:Antioxidants; D016166:Free Radical Scavengers; D005978:Glutathione; D000111:Acetylcysteine
keywords: N-acetylcysteine; NAC; mechanism of action; psychiatry