Review Article

N-Acetylcysteine for the Treatment of Psychiatric Disorders: A Review of Current Evidence

Table 1

Summary of included reviews: N-acetylcysteine for addiction and substance abuse disorders.

Authors (Year)TypeInclusionNo. Studies (Study Size)Conclusion

Asevedo et al. (2014) [14]SRClinical trials that assessed NAC with outcomes related to an addiction.Total = 9 (n = 295):
Cocaine = 3 (n = 60);
Cannabis = 2 (n = 140);
Nicotine = 2 (n = 51);
Methamphetamine = 1 (n = 31);
Gambling = 1 (n = 13)
Included studies suggest a potential role for NAC in the treatment of addiction, especially cocaine and cannabis dependence.

Deepmala et al. (2015) [15]SRClinical trials of psychiatric and neurological disorders which reported a direct clinical effect of NAC as an outcome.Total = 19 (n = 781):
Cocaine = 5 (n = 168);
Cannabis = 3 (n = 229);
Nicotine = 6 (n = 253);
Methamphetamine = 2 (n = 63);
Gambling = 3 (n = 68)
Limited evidence for NAC as a treatment for addiction. Positive results for cocaine, but only for those who were abstinent. Some evidence for cannabis, even though results are inconsistent. Premature to make recommendations for or against the use of NAC in other types of addiction.

Minarini et al. (2017) [16]SRClinical trials that assessed NAC use as the independent variable and clinical outcomes related to a psychiatric disorder.Total = 18 (n = 711):
Cocaine = 5 (n = 168);
Cannabis = 4 (n = 252);
Nicotine = 6 (n = 188);
Methamphetamine = 2 (n = 63);
Gambling = 1 (n = 40)
The clinical usefulness of NAC for SUDs, apart from cannabis use disorder in young people, is not currently supported by good enough evidence.

Nocito Echevarria et al. (2017) [17]SRHuman or animal studies using NAC as an intervention for cocaine dependence.Total (Cocaine) = 6 (n = 188) (Human trials only)Promising data from preliminary studies, but results from a double-blind placebo trial was mainly negative. Current data suggest NAC may be better suited for avoiding relapse in already abstinent subjects.

Duailibi et al. (2017) [18]SR+MARCTs of NAC for treatment of SUD with standardized assessment of craving.Total = 7 (n = 245):
Cocaine = 2 (n = 43);
Cannabis = 1 (n = 89);
Nicotine = 3 (n = 67);
Methamphetamine = 1 (n = 46)
NAC was significantly superior for reducing craving symptoms compared to placebo (Hedges’ g = 0.94; 95% CI: 0.55–1.33). NAC has a potential clinical use for craving in SUDs.

Abbreviation. Confidence interval (CI); meta-analysis (MA); N-acetylcysteine (NAC); randomised control trial (RCT); substance use disorder (SUD); systematic review (SR).