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The Role of N-Acetylcysteine in Obsessive-Compulsive (OCD) and Related Disorders

Published online by Cambridge University Press:  01 September 2022

J. Sá Couto*
Affiliation:
Centro Hospitalar Universitário do Algarve, Departamento De Psiquiatria E Saúde Mental, Unidade De Faro, Faro, Portugal
J. Rodrigues
Affiliation:
Centro Hospitalar Universitário do Algarve, Departamento De Psiquiatria E Saúde Mental, Unidade De Faro, Faro, Portugal
M. Pão Trigo
Affiliation:
Centro Hospitalar Universitário do Algarve, Departamento De Psiquiatria E Saúde Mental, Unidade De Faro, Faro, Portugal
B. Da Luz
Affiliation:
Centro Hospitalar Universitário do Algarve, Departamento De Psiquiatria E Saúde Mental, Unidade De Faro, Faro, Portugal
T. Ventura Gil
Affiliation:
Centro Hospitalar Universitário do Algarve, Departamento De Psiquiatria E Saúde Mental, Unidade De Faro, Faro, Portugal
*
*Corresponding author.

Abstract

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Introduction

N-acetylcysteine is known for its uses in non-psychiatric conditions, such as paracetamol overdose and as a mucolytic. The rationale for its administration in psychiatric conditions is based on its ability reducing synaptic glutamate release, which was found to be increased in the cerebrospinal fluid of OCD patients.

Objectives

Evaluating N-acetylcysteine efficacy in OCD symptoms. Studying mechanisms underlying its action. Identifying the frequency of side effects.

Methods

PubMed database search, with the “N-acetylcysteine obsessive compulsive” keyword expression. The search was restricted to English-only articles, published in the last ten years. Twenty-five results among the best match correspondence were selected. Reference lists of articles were reviewed to identify additional articles.

Results

Oliver et al. found that a daily dose of 2.400 to 3.000 milligrams of N-acetylcysteine reduced the severity of obsessive-compulsive symptoms with minimal side effects; Smith et al. found inconclusive evidence on its efficacy. A clinical trial from Ghazinadeh et al. revealed N-acetylcysteine to be effective as an add-on to citalopram, reducing the score of resistance/control to obsessions after supplementing with N-acetylcysteine. Costa et al. found out it was superior to placebo in anxiety control as a secondary outcome.

Conclusions

The potential efficacy of N-acetylcysteine in the treatment of psychiatric disorders attracted interest. Mixed evidence was found that N-acetylcysteine may have some benefits controlling compulsions, both as an adjunctive as and as monotherapy. Thus, larger and more robust studies are required to further investigate the clinical effectiveness of N-acetylcysteine in this area.

Disclosure

No significant relationships.

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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