Clin Psychopharmacol Neurosci.  2015 Apr;13(1):12-24. 10.9758/cpn.2015.13.1.12.

N-Acetyl Cysteine in the Treatment of Obsessive Compulsive and Related Disorders: A Systematic Review

Affiliations
  • 1Department of Psychiatry, The Melbourne Clinic, The University of Melbourne, Melbourne, Australia. georgina.oliver@unimelb.edu.au
  • 2Innovation in Mental and Physical Health and Clinical Treatment: Strategic Research Centre, School of Medicine, Deakin University, Geelong, Australia.
  • 3The Florey Institute of Neuroscience and Mental Health, Swinburne University, Melbourne, Australia.
  • 4Centre for Human Psychopharmacology, Swinburne University, Melbourne, Australia.
  • 5Illawarra Health & Medical Research Institute (IHMRI), University of Wollongong, Wollongong, Australia.
  • 6School of Psychology, University of Wollongong, Wollongong, Australia.

Abstract

OBJECTIVE: Obsessive compulsive and related disorders are a collection of debilitating psychiatric disorders in which the role of glutamate dysfunction in the underpinning neurobiology is becoming well established. N-acetyl cysteine (NAC) is a glutamate modulator with promising therapeutic effect. This paper presents a systematic review of clinical trials and case reports exploring the use of NAC for these disorders. A further objective was to detail the methodology of current clinical trials being conducted in the area.
METHODS
PubMed, Web of Science and Cochrane Library Database were searched for human clinical trials or case reports investigating NAC in the treatment of obsessive compulsive disorder (OCD) or obsessive compulsive related disorders. Researchers with known involvement in NAC studies were contacted for any unpublished data.
RESULTS
Four clinical trials and five case reports/series were identified. Study durations were commonly 12-weeks, using 2,400-3,000 mg/day of NAC. Overall, NAC demonstrates activity in reducing the severity of symptoms, with a good tolerability profile and minimal adverse effects. Currently there are three ongoing randomized controlled trials using NAC for OCD (two adults and one pediatric), and one for excoriation.
CONCLUSION
Encouraging results have been demonstrated from the few pilot studies that have been conducted. These results are detailed, in addition to a discussion of future potential research.

Keyword

Obsessive-compulsive disorder; Trichotillomania, acetylcysteine; Glutamate; Review, systematic
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