TY - JOUR
T1 - N-Acetylcysteine as a novel rapidly acting anti-suicidal agent
T2 - A pilot naturalistic study in the emergency setting
AU - Hans, Davinder
AU - Rengel, Anthony
AU - Hans, Jaspreet
AU - Bassett, Darryl
AU - Hood, Sean
PY - 2022/1/28
Y1 - 2022/1/28
N2 - Objective N-acetylcysteine has a demonstrated role as an adjunctive therapy in psychotic and affective disorders as a treatment to reduce symptoms of Bipolar Affective Disorder, Major Depressive Disorder and Schizophrenia. However, its potential as a rapidly acting anti-suicidal agent has not yet been assessed. This naturalistic study evaluates its effect in thirty patients presenting following intentional medication overdose. Methods Eighteen patients who ingested toxic doses of paracetamol received NAC whilst twelve other patients with other overdoses received standard supportive treatment in the emergency department setting. Symptoms were measured using the Montgomery-Asberg Depression Rating Scale and Clinical Global Impression scale at time of presentation, 24 hours, and seven days. Results Baseline characteristics between groups were similar. Both groups showed a significant reduction in suicidality, as measured by the suicide item of the MADRS, over time (p < 0.001). However, there was a greater reduction in suicidality in the 'NAC group' compared to the 'no-NAC group' one-week post presentation (p = 0.014). A greater proportion of the 'no-NAC group' still exhibited severe depressive symptoms (MADRS >32) compared to the 'NAC group' (p = 0.044). Conclusion This naturalistic study suggests NAC may have potential use as a rapidly acting treatment adjunct in major depressive disorder, warranting further investigation of its effects.
AB - Objective N-acetylcysteine has a demonstrated role as an adjunctive therapy in psychotic and affective disorders as a treatment to reduce symptoms of Bipolar Affective Disorder, Major Depressive Disorder and Schizophrenia. However, its potential as a rapidly acting anti-suicidal agent has not yet been assessed. This naturalistic study evaluates its effect in thirty patients presenting following intentional medication overdose. Methods Eighteen patients who ingested toxic doses of paracetamol received NAC whilst twelve other patients with other overdoses received standard supportive treatment in the emergency department setting. Symptoms were measured using the Montgomery-Asberg Depression Rating Scale and Clinical Global Impression scale at time of presentation, 24 hours, and seven days. Results Baseline characteristics between groups were similar. Both groups showed a significant reduction in suicidality, as measured by the suicide item of the MADRS, over time (p < 0.001). However, there was a greater reduction in suicidality in the 'NAC group' compared to the 'no-NAC group' one-week post presentation (p = 0.014). A greater proportion of the 'no-NAC group' still exhibited severe depressive symptoms (MADRS >32) compared to the 'NAC group' (p = 0.044). Conclusion This naturalistic study suggests NAC may have potential use as a rapidly acting treatment adjunct in major depressive disorder, warranting further investigation of its effects.
UR - http://www.scopus.com/inward/record.url?scp=85123702736&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0263149
DO - 10.1371/journal.pone.0263149
M3 - Article
C2 - 35089954
AN - SCOPUS:85123702736
SN - 1932-6203
VL - 17
JO - PLoS One
JF - PLoS One
IS - 1 January
M1 - e0263149
ER -