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N-acetylcysteine for major mental disorders: a systematic review and meta-analysis of randomized controlled trials
journal contribution
posted on 2018-05-01, 00:00 authored by W Zheng, Q-E Zhang, D-B Cai, X-H Yang, Y Qiu, G S Ungvari, C H Ng, Michael BerkMichael Berk, Y-P Ning, Y-T XiangOBJECTIVE: 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.
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Journal
Acta psychiatrica ScandinavicaVolume
137Issue
5Pagination
391 - 400Publisher
WileyLocation
Chichester, Eng.Publisher DOI
eISSN
1600-0447Language
engPublication classification
C1 Refereed article in a scholarly journalCopyright notice
2018, John Wiley & SonsUsage metrics
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