Effects of 12-month, double-blind N-acetyl cysteine on symptoms, cognition and brain morphology in early phase schizophrenia spectrum disorders

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Abstract
Background

Currently approved medications for schizophrenia are relatively ineffective for negative symptoms and cognitive impairment. N-Acetyl Cysteine (NAC) is a neuroprotective agent that improved general symptoms, cognitive impairment and negative symptoms in some but not all studies, but failed to improve positive symptoms in patients with schizophrenia. Progressive brain mass loss (PBML) has been consistently observed in early phase schizophrenia. NAC mitigates the deleterious effects oxidative stress, inflammation and glutamatergic excitotoxicity and these three pathological processes are hypothesized to contribute to PBML.
Methods

In this study, we assessed the effects NAC (3600 mg/day) in a 52-week, double-blind, placebo controlled trial on symptoms, and cognition in early phase schizophrenia spectrum disorders (N = 60). In the context of the clinical trial, we explored the effects of NAC on brain morphology.
Results

NAC significantly improved (time × group) PANSS total (F = 14.7, p < 0.001), negative (F = 5.1, p = 0.024) and disorganized thought (F = 13.7, p < 0.001) symptom scores. NAC failed to improve PANSS positive symptoms and BACS cognitive scores. In preliminary analyses, baseline right (r = −0.48, p = 0.041) and left (r = −0.45, p = 0.018) total cortical thickness, and thickness in other cortical regions, were associated with NAC related improvement in PANSS total scores, but NAC, as compared to placebo, did not significantly impact brain morphology over the study treatment period.
Conclusions

These results replicate some but not all previous findings of NAC efficacy. Preliminary results suggest that NAC’s symptom effects may be related to structural integrity, but NAC failed to demonstrate treatment effects on longitudinal measures of brain morphology.

ClinicalTrials.gov Identifier: NCT01339858
Keywords:
N-acetyl cysteine, Early phase schizophrenia spectrum disorders, Negative symptoms, Positive symptoms, Cognitive impairment, Progressive brain mass loss

http://www.schres-journal.com/article/S0920-9964(18)30164-6/fulltext?rss=yes

4 Likes
2

I wish I could take NAC. I think it may interact slightly with abilify but I’m not sure. It made me very muggy /foggy headed.

3

I get the impression, I may be wrong, that there are mixed feelings about NAC.

Poll for those who have taken it.

  • Made things much better
  • Made things quite a lot better
  • Made things a little better
  • No difference
  • Made things a little worse
  • Made things quite a bit worse
  • Made things much worse.

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4

Ignore the quite a lot better vote so far. That was me accidentally clicking one of the choices(duh!) .