Work

N ‐acetylcysteine for major mental disorders: a systematic review and meta‐analysis of randomized controlled trials

Year: 2018

Type: review

Study designs: Systematic Review, Meta-Analysis

Abstract: Objective This systematic review and meta‐analysis of randomized controlled trials ( RCT s) examined the efficacy and safety of adjunctive N ‐acetylcysteine ( NAC ), an antioxidant drug, in treating major depressive disorder ( MDD ), bipolar disorder, and schizophrenia. Methods The PubMed, Cochrane Library, Psyc INFO , CNKI , CBM , and WanFang databases were independently searched and screened by two researchers. Standardized mean differences ( SMD s), risk ratios, and their 95% confidence intervals ( CI s) were computed. Results Six RCT s ( n = 701) of NAC for schizophrenia (three RCT s, n = 307), bipolar disorder (two RCT s, n = 125), and MDD (one RCT , n = 269) were identified and analyzed as separate groups. Adjunctive NAC significantly improved total psychopathology ( SMD = −0.74, 95% CI : −1.43, −0.06; I 2 = 84%, P = 0.03) in schizophrenia, but it had no significant effect on depressive and manic symptoms as assessed by the Young Mania Rating Scale in bipolar disorder and only a small effect on major depressive symptoms. Adverse drug reactions to NAC and discontinuation rates between the NAC and control groups were similar across the three disorders. Conclusions Adjunctive NAC appears to be a safe treatment that has efficacy for schizophrenia, but not for bipolar disorder or MDD . Further higher quality RCT s are warranted to determine the role of adjunctive NAC in the treatment of major psychiatric disorders.

Source: Acta Psychiatrica Scandinavica

DOI: 10.1111/acps.12862