Maintenance N-acetyl cysteine treatment for bipolar disorder: A double-blind randomized placebo controlled trial

Berk, Michael; Dean, Olivia; Cotton, Sue; Gama, Clarissa Severino; Kapczinski, Flávio; Fernandes, Brisa S.; Kohlmann, Kristy; Jeavons, Sue; Hewitt, Karen; Moss, Kirsteen; Allwang, Christine; Schapkaitz, Ian; Cobb, Heidi; Bush, Ashley I.; Dodd, Seetal; Malhi, Gin S

doi:10.1186/1741-7015-10-91

Cited by 87 publications

(72 citation statements)

References 35 publications

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“…23 Statistical analysis was conducted blind to treatment allocation. All analyses were conducted in accordance with the International Conference on Harmonization E9 statistical principles.…”

Section: Statistical Analysesmentioning

confidence: 99%

“…38 N-acetylcysteine has been shown to be potentially efficacious in a bewildering array of divergent disorders, from bipolar disorder 10,15,23 to schizophrenia, 6,14 obsessive-compulsive disorder, 39 nailbiting, 40 autism, 41 attention-deficit/hyperactivity disorder, 42 cocaine and cannabis abuse, 43 smoking, and blast traumatic brain injury, 44 although there are negative studies, including those in bulimia 45 and pediatric trichotillomania, 46 and the methodological quality of trials is highly variable. 4 As N-acetylcysteine has multiple mechanisms of action, it remains to be clarified if it works on common targets across disorders, such as oxidative stress or inflammation, or if some actions, such as glutamate-cysteine exchange, are more important to some disorders than others, such as addictions.…”

Section: Figure 2 Mean ± Se Estimates From Mixed-effects Model Repeamentioning

confidence: 99%

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The Efficacy of AdjunctiveN-Acetylcysteine in Major Depressive Disorder

Berk

Dean²,

Cotton³

et al. 2014

J. Clin. Psychiatry

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151

138

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Objective: Major depressive disorder (MDD) is one of the most common psychiatric disorders, conferring considerable individual, family, and community burden. To date, treatments for MDD have been derived from the monoamine hypothesis, and there is a paucity of emerging antidepressants, especially with novel mechanisms of action and treatment targets. N-acetylcysteine (NAC) is a redox-active glutathione precursor that decreases inflammatory cytokines, modulates glutamate, promotes neurogenesis, and decreases apoptosis, all of which contribute to the neurobiology of depression.Method: Participants with a current episode of MDD diagnosed according to DSM-IV-TR criteria (N = 252) were treated with NAC or placebo in addition to treatment as usual for 12 weeks and were followed to 16 weeks. Data were collected between 2007 and 2011. Results:The omnibus interaction between group and visit for the Montgomery-Asberg Depression Rating Scale (MADRS), the primary outcome measure, was not significant (F 1,520.9 = 1.98, P = .067), and the groups did not separate at week 12 (t 360.3 = −1.12, P = .265). However, at week 12, the scores on the Longitudinal Interval Follow-Up Evaluation-Range of Impaired Functioning Tool (LIFE-RIFT) differed from placebo (P = .03). Among participants with a MADRS score ≥ 25, NAC separated from placebo at weeks 6, 8, 12, and 16 (P < .05). Additionally, the rate of change between baseline and week 16 was significant (t 221.03 = −2.11, P = .036). NAC treatment was superior to placebo at week 16 for secondary readouts of function and clinical impression. Remission and response were greater in the NAC group at week 16, but not at week 12. The NAC group had a greater rate of gastrointestinal and musculoskeletal adverse events. Conclusions:Being negative at the week 12 end point, and with some positive secondary signals, the study provides only limited support for the role of NAC as a novel adjunctive therapy for MDD. These data implicate the pathways influenced by NAC in depression pathogenesis, principally oxidative and inflammatory stress and glutamate, although definitive confirmation remains necessary.Trial Registration: www.anzctr.org.au Identifier: ACTRN12607000134426 Clin Psychiatry 2014;75(6):628-636 J

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Section: Statistical Analysesmentioning

confidence: 99%

Section: Figure 2 Mean ± Se Estimates From Mixed-effects Model Repeamentioning

confidence: 99%

The Efficacy of AdjunctiveN-Acetylcysteine in Major Depressive Disorder

Berk

Dean²,

Cotton³

et al. 2014

J. Clin. Psychiatry

Self Cite

151

138

View full text Add to dashboard Cite

show abstract

“…A 6-month double-blind RCT of add-on NAC to standard treatment showed a significant positive effect for depressive symptoms and functional outcome [87,88]. However, a study using NAC for the maintenance of bipolar disorder observed no result in recurrence or symptomatic outcomes [89]. …”

Section: The Future Of Research On Inflammation In Mddmentioning

confidence: 99%

Targeting the Inflammatory Pathway as a Therapeutic Tool for Major Depression

Noto¹,

Rizzo²,

Mansur³

et al. 2014

Neuroimmunomodulation

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In the last decades convergent findings from several lines of evidence has revealed a robust association between major depressive disorder (MDD) and inflammatory pathways. Despite this, the translation of these findings into new and better treatments for MDD has not occurred. The objective of this study is to comprehensively review what is already known with reasonable certainty on inflammatory pathways in MDD, to clarify some points that have been insufficiently studied and to discuss the implications of these findings for future studies targeting inflammatory pathways as a therapeutic tool for individuals with MDD.

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“…The school newspaper information includes the school newspaper's header information, publishing units, organizers, competent authorities, authoritative email address, contact ways, etc. [6]. The…”

Section: Demand Analysis Of the School Newspaper Management Systemmentioning

confidence: 99%

Development of College Newspaper Management System Based on Mobile Devices

He¹,

Feng²

2018

Proceedings of the 2018 International Conference on Network, Communication, Computer Engineering (NCCE 2018)

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Abstract. In order to adapt to the huge impact and influence brought by the mobile networks as well as the Internet to the university newspaper, it is imperative to implement an intelligent, digitalized school newspaper management system. Based on mobile devices, the hierarchical structure of the program was designed according to the MVC framework in ASP.NET development on the basis of mobile devices, and the process design of the operation business was carried out respectively for the user end, the front end, the school newspaper editorial management system, and the website background management system, so that the scientific management of the university was realized. In addition, all-around information collection, highspeed processing, high-density storage and long-distance transmission were realized by the users, which enabled people to search for the required information in a comprehensive, fast, and accurate manner. Thus, the information resources could be developed and used more effectively. The results showed that the design and development of college newspaper management system could bring convenience to users and schools.

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Maintenance N-acetyl cysteine treatment for bipolar disorder: A double-blind randomized placebo controlled trial

Cited by 87 publications

References 35 publications

The Efficacy of AdjunctiveN-Acetylcysteine in Major Depressive Disorder

The Efficacy of AdjunctiveN-Acetylcysteine in Major Depressive Disorder

Targeting the Inflammatory Pathway as a Therapeutic Tool for Major Depression

Development of College Newspaper Management System Based on Mobile Devices

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