Adjunctive N-acetylcysteine in depression: exploration of interleukin-6, C-reactive protein and brain-derived neurotrophic factor.
OBJECTIVE
This study aimed to explore effects of adjunctive N-acetylcysteine (NAC) treatment on inflammatory and neurogenesis markers in unipolar depression.


METHODS
We embarked on a 12-week clinical trial of NAC (2000 mg/day compared with placebo) as an adjunctive treatment for unipolar depression. A follow-up visit was conducted 4 weeks following the completion of treatment. We collected serum samples at baseline and the end of the treatment phase (week 12) to determine changes in interleukin-6 (IL6), C-reactive protein (CRP) and brain-derived neurotrophic factor (BDNF) following NAC treatment.


RESULTS
NAC treatment significantly improved depressive symptoms on the Montgomery-Asberg Depression Rating Scale (MADRS) over 16 weeks of the trial. Serum levels of IL6 were associated with reductions of MADRS scores independent of treatment response. However, we found no significant changes in IL6, CRP and BDNF levels following NAC treatment.


CONCLUSIONS
Overall, this suggests that our results failed to support the hypothesis that IL6, CRP and BDNF are directly involved in the therapeutic mechanism of NAC in depression. IL6 may be a useful marker for future exploration of treatment response.
1School of Medicine,Centre for Molecular and Medical Research,Deakin University,Geelong,Australia.
Kyoko
K
Hasebe
1School of Medicine,Centre for Molecular and Medical Research,Deakin University,Geelong,Australia.
Laura
L
Gray
1School of Medicine,Centre for Molecular and Medical Research,Deakin University,Geelong,Australia.
Chiara
C
Bortolasci
4Laboratory of Molecular Psychiatry,Hospital de clínicas de Porto Alegre,Universidade Federal do Rio Grande do Sul,Porto Alegre,Brazil.
Bruna
B
Panizzutti
5School of Medicine,IMPACT Strategic Research Centre,Deakin University,Geelong,Australia.
Mohammadreza
M
Mohebbi
1School of Medicine,Centre for Molecular and Medical Research,Deakin University,Geelong,Australia.
Srisaiyini
S
Kidnapillai
1School of Medicine,Centre for Molecular and Medical Research,Deakin University,Geelong,Australia.
Briana
B
Spolding
1School of Medicine,Centre for Molecular and Medical Research,Deakin University,Geelong,Australia.
Ken
K
Walder
2The Florey Institute of Neuroscience and Mental Health,Parkville,Australia.
Michael
M
Berk
8Discipline of Psychiatry,Sydney Medical School,University of Sydney,Sydney,Australia.
Gin
G
Malhi
5School of Medicine,IMPACT Strategic Research Centre,Deakin University,Geelong,Australia.
Seetal
S
Dodd
2The Florey Institute of Neuroscience and Mental Health,Parkville,Australia.
Olivia M
OM
Dean
D000111:Acetylcysteine / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D019208:Brain-Derived Neurotrophic Factor / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis*; D003866:Depressive Disorder / Q000097:blood / Q000188:drug therapy*; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome; D055815:Young Adult
D000928:Antidepressive Agents; D015415:Biomarkers; D019208:Brain-Derived Neurotrophic Factor; D015850:Interleukin-6; C579455:BDNF protein, human; D002097:C-Reactive Protein; D000111:Acetylcysteine

               N-acetylcysteine; clinical trial; depression; inflammation; neurotrophic factor