TY - JOUR
T1 - N-acetylcysteine for major mental disorders
T2 - a systematic review and meta-analysis of randomized controlled trials
AU - Zheng, W.
AU - Zhang, Q. E.
AU - Cai, D. B.
AU - Yang, X. H.
AU - Qiu, Y.
AU - Ungvari, G. S.
AU - Ng, C. H.
AU - Berk, M.
AU - Ning, Y. P.
AU - Xiang, Y. T.
PY - 2018/5/1
Y1 - 2018/5/1
N2 - Objective: This systematic review and meta-analysis of randomized controlled trials (RCTs) 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, PsycINFO, CNKI, CBM, and WanFang databases were independently searched and screened by two researchers. Standardized mean differences (SMDs), risk ratios, and their 95% confidence intervals (CIs) were computed. Results: Six RCTs (n = 701) of NAC for schizophrenia (three RCTs, n = 307), bipolar disorder (two RCTs, 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; I2 = 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 RCTs are warranted to determine the role of adjunctive NAC in the treatment of major psychiatric disorders.
AB - Objective: This systematic review and meta-analysis of randomized controlled trials (RCTs) 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, PsycINFO, CNKI, CBM, and WanFang databases were independently searched and screened by two researchers. Standardized mean differences (SMDs), risk ratios, and their 95% confidence intervals (CIs) were computed. Results: Six RCTs (n = 701) of NAC for schizophrenia (three RCTs, n = 307), bipolar disorder (two RCTs, 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; I2 = 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 RCTs are warranted to determine the role of adjunctive NAC in the treatment of major psychiatric disorders.
KW - bipolar disorder
KW - major depressive disorder
KW - N-acetylcysteine
KW - oxidative stress
KW - schizophrenia
UR - http://www.scopus.com/inward/record.url?scp=85045148315&partnerID=8YFLogxK
U2 - 10.1111/acps.12862
DO - 10.1111/acps.12862
M3 - Article
C2 - 29457216
AN - SCOPUS:85045148315
VL - 137
SP - 391
EP - 400
JO - Acta Pyschiatrica Scandinavica
JF - Acta Pyschiatrica Scandinavica
SN - 0001-690X
IS - 5
ER -
