N-Acetyl Cysteine for Depressive Symptoms in Bipolar Disorder—A Double-Blind Randomized Placebo-Controlled Trial

Berk, Michael; Copolov, David L.; Dean, Olivia; Lu, Kristy; Jeavons, Sue; Schapkaitz, Ian; Anderson-Hunt, Murray; Bush, Ashley I.

doi:10.1016/j.biopsych.2008.04.022

Cited by 449 publications

(346 citation statements)

References 34 publications

Supporting

Mentioning

330

Contrasting

Unclassified

Order By: Relevance

“…Ancillary treatments such as adjunctive eicosapentaenoic acid (EPA) (level 2),169, 279, 280 N ‐acetylcysteine (level 3),281 and light therapy (level 3),282 including bright light delivered midday (level 3),283 are also recommended as third‐line treatment options to use adjunctively to other medications. There may be additional benefits to using light therapy in combination with total sleep deprivation (level 2), although there is little clinical experience with this technique.…”

Section: Acute Management Of Bipolar Depressionmentioning

confidence: 99%

“…A small study suggests that lithium may be effective for reducing substance use in this population (level 3),617 and FFT should also be considered (Section 2). Positive trials of N ‐acetylcysteine for cannabis use disorders among adolescents,618 smoking,619 and bipolar depression among adults 281 suggest that N ‐acetylcysteine may benefit adolescents with comorbid bipolar and SUDs; however, studies examining this hypothesis have not yet been completed (level 4).…”

Section: Specific Populationsmentioning

confidence: 99%

See 1 more Smart Citation

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

et al. 2018

Self Cite

View full text Add to dashboard Cite

The Canadian Network for Mood and Anxiety Treatments (CANMAT) previously published treatment guidelines for bipolar disorder in 2005, along with international commentaries and subsequent updates in 2007, 2009, and 2013. The last two updates were published in collaboration with the International Society for Bipolar Disorders (ISBD). These 2018 CANMAT and ISBD Bipolar Treatment Guidelines represent the significant advances in the field since the last full edition was published in 2005, including updates to diagnosis and management as well as new research into pharmacological and psychological treatments. These advances have been translated into clear and easy to use recommendations for first, second, and third‐ line treatments, with consideration given to levels of evidence for efficacy, clinical support based on experience, and consensus ratings of safety, tolerability, and treatment‐emergent switch risk. New to these guidelines, hierarchical rankings were created for first and second‐ line treatments recommended for acute mania, acute depression, and maintenance treatment in bipolar I disorder. Created by considering the impact of each treatment across all phases of illness, this hierarchy will further assist clinicians in making evidence‐based treatment decisions. Lithium, quetiapine, divalproex, asenapine, aripiprazole, paliperidone, risperidone, and cariprazine alone or in combination are recommended as first‐line treatments for acute mania. First‐line options for bipolar I depression include quetiapine, lurasidone plus lithium or divalproex, lithium, lamotrigine, lurasidone, or adjunctive lamotrigine. While medications that have been shown to be effective for the acute phase should generally be continued for the maintenance phase in bipolar I disorder, there are some exceptions (such as with antidepressants); and available data suggest that lithium, quetiapine, divalproex, lamotrigine, asenapine, and aripiprazole monotherapy or combination treatments should be considered first‐line for those initiating or switching treatment during the maintenance phase. In addition to addressing issues in bipolar I disorder, these guidelines also provide an overview of, and recommendations for, clinical management of bipolar II disorder, as well as advice on specific populations, such as women at various stages of the reproductive cycle, children and adolescents, and older adults. There are also discussions on the impact of specific psychiatric and medical comorbidities such as substance use, anxiety, and metabolic disorders. Finally, an overview of issues related to safety and monitoring is provided. The CANMAT and ISBD groups hope that these guidelines become a valuable tool for practitioners across the globe.

show abstract

Section: Acute Management Of Bipolar Depressionmentioning

confidence: 99%

Section: Specific Populationsmentioning

confidence: 99%

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

et al. 2018

Self Cite

View full text Add to dashboard Cite

show abstract

“…173 A double-blind, placebo-controlled adjunctive study showed that the antioxidant N-acetylcysteine improved functioning and depressive symptoms in patients with BD after 24 weeks, compared with placebo treatment. 174 Other compounds acting as general intracellular antioxidants include ascorbic acid (vitamin C), a-tocopherol (vitamin E), b-carotene, and a-lipoic acid. 175,176 All these compounds are naturally present in the cell, but their levels can be increased by exogenous supplementation.…”

Section: Mitochondria As a Pharmacological Target For Psychiatric Dismentioning

confidence: 99%

Mitochondria and the central nervous system: searching for a pathophysiological basis of psychiatric disorders

Streck

Gonçalves

Furlanetto

et al. 2014

Rev. Bras. Psiquiatr.

View full text Add to dashboard Cite

Introduction: Mitochondrial dysfunction has been postulated to participate in the development of many neuropsychiatric disorders, but there is no consensus as to its role. The aim of this paper is to review recent studies and to outline the current understanding of the association between mitochondrial dysfunction and psychiatric disorders. Methodology: We reviewed articles that evaluated mitochondrial dysfunction and psychiatric disorders, with a particular focus on depression, bipolar disorder, anxiety disorders, obsessivecompulsive disorder, and autism spectrum disorder, and the association between mitochondrial dysfunction and development of these disorders. Results: Evidence suggests that alterations in mitochondrial morphology, brain energy metabolism, and mitochondrial enzyme activity may be involved in the pathophysiology of different neuropsychiatric disorders, given their key role in energy metabolism in the cell. Conclusions: Understanding the interactions between mitochondrial dysfunction and development of psychiatric disorders may help establish more effective therapeutic strategies for these disorders and thus lead to better outcomes for affected subjects.

show abstract

“…NAC levels can also regulate dopamine release (56). Some clinical trial NAC treatment appears to show favorable effects for depressive symptoms in bipolar disorder (57) and schizophrenia (58).…”

Section: Amino Acid and Proteinsmentioning

confidence: 99%

“…Despite it has been shown auspicious results in other psychiatric diseases (279,280) there is no sufficient data of the use this compound in the management of AD.…”

Section: Quality Of the Evidencementioning

confidence: 99%

Nutritional strategies in the management of Alzheimer\'s disease: systematic review and meta-analysis

Fernández¹,

Steffany²

View full text Add to dashboard Cite

N-Acetyl Cysteine for Depressive Symptoms in Bipolar Disorder—A Double-Blind Randomized Placebo-Controlled Trial

Cited by 449 publications

References 34 publications

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

Mitochondria and the central nervous system: searching for a pathophysiological basis of psychiatric disorders

Nutritional strategies in the management of Alzheimer\'s disease: systematic review and meta-analysis

Contact Info

Product

Resources

About