N-acetylcysteine for treating cocaine addiction – A systematic review

Echevarria, Marco Antonio Nocito; Reis, Tassio Andrade; Capatti, Giulianno Ruffo; Soares, Victor Siciliano; Silveira, Dartiu Xavier da; Fidalgo, Thiago M.

doi:10.1016/j.psychres.2017.02.024

Cited by 45 publications

(45 citation statements)

References 32 publications

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“…Clinical trials using NAC to treat drug addiction have been systematically reviewed recently ( Deepmala et al, 2015 ; Nocito Echevarria et al, 2017 ). There are 5 NAC clinical trials for cocaine dependence.…”

Section: Preclinical Modelsmentioning

confidence: 99%

Glutamate Transport: A New Bench to Bedside Mechanism for Treating Drug Abuse

Spencer

Kalivas

2017

International Journal of Neuropsychopharmacology

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Drug addiction has often been described as a “hijacking” of the brain circuits involved in learning and memory. Glutamate is the principal excitatory neurotransmitter in the brain, and its contribution to synaptic plasticity and learning processes is well established in animal models. Likewise, over the past 20 years the addiction field has ascribed a critical role for glutamatergic transmission in the development of addiction. Chronic drug use produces enduring neuroadaptations in corticostriatal projections that are believed to contribute to a maladaptive deficit in inhibitory control over behavior. Much of this research focuses on the role played by ionotropic glutamate receptors directly involved in long-term potentiation and depression or metabotropic receptors indirectly modulating synaptic plasticity. Importantly, the balance between glutamate release and clearance tightly regulates the patterned activation of these glutamate receptors, emphasizing an important role for glutamate transporters in maintaining extracellular glutamate levels. Five excitatory amino acid transporters participate in active glutamate reuptake. Recent evidence suggests that these glutamate transporters can be modulated by chronic drug use at a variety of levels. In this review, we synopsize the evidence and mechanisms associated with drug-induced dysregulation of glutamate transport. We then summarize the preclinical and clinical data suggesting that glutamate transporters offer an effective target for the treatment of drug addiction. In particular, we focus on the role that altered glutamate transporters have in causing drug cues and contexts to develop an intrusive quality that guides maladaptive drug seeking behaviors.

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Section: Preclinical Modelsmentioning

confidence: 99%

Glutamate Transport: A New Bench to Bedside Mechanism for Treating Drug Abuse

Spencer

Kalivas

2017

International Journal of Neuropsychopharmacology

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“…La N-acétyl cystéine peut normaliser les taux de glutamate et diminuer le comportement de recherche de cocaïne. Son action anticraving est surtout efficace chez des patients déjà abstinents, à des posologies comprises entre 1200 et 3600 mg/J [60].…”

Section: Principes De Prise En Chargeunclassified

Conduites addictives : faits cliniques

Lucet

Olié

2020

Bulletin de l'Académie Nationale de Médecine

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Déclaration de liens d'intérêt : aucun *Étant donné le contexte sanitaire épidémique lié au Covid-19 du mois de mars 2020, la présentation orale de cette communication en séance à l'Académie a été reportée. MC : Médecine de l'addiction KW : Addiction Medicine RésuméMalgré les fréquentes comorbidités psychiatriques, le trouble de l'usage de substance doit être appréhendé comme une pathologie autonome par ses déterminants, sa sémiologie et ses modalités évolutives spontanées ou sous traitement. De multiples produits de synthèse sont désormais accessibles via internet : associé à la créativité des chimistes cela a participé à l'émergence de pratiques inédites allant du chemsex au purple drank.Les conduites addictives résultent d'un ensemble de facteurs individuels (vulnérabilités biologique et psychique) et contextuels (disponibilité et banalisation du toxique dans l'environnement). Les pathologies mentales autres sont des facteurs de vulnérabilité à la pathologie addictive, tout comme les conduites addictives peuvent révéler une pathologie émotionnelle ou psychotique.Le médecin se doit d'entendre l'impuissance du malade face au besoin irrépressible de consommer (craving) et proposer une thérapeutique qui peut être chimique (y compris traitement de substitution) et psychologique. Dans la majorité des cas un accompagnement social s'impose pour corriger les effets désocialisants du trouble de l'usage de substances ou des comportements addictifs. AbstractDespite the frequency of psychiatric comorbidities, substance use disorder must be understood as an autonomous pathology due to its own determinants, semiology and possibilities of evolution, either spontaneous or under treatment.The ease of access to multiple synthetic products via the Internet combined with the creativity of chemists are contributing to the emergence of novel practices ranging from chemsex to purple drank.

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“…While not providing clear results, randomized clinical trials have pointed towards certain mechanistic and methodological factors through which NAC could promote abstinence and help prevent relapses with different substances of abuse (3). In recent findings, NAC is suggested to be most effective in maintaining abstinence rather than in promoting initial cessation (12,41,42). Despite inconsistent results in human clinical trials (41,43,44), the latest systematic review and meta-analysis found NAC to be significantly superior to placebo for reducing craving symptoms in SUDs.…”

Section: Substance Use Disorders and N-acetylcysteinementioning

confidence: 99%

“…While findings have been mixed, they seem to suggest efficacy over placebo to prolong abstinence and reduce cue-related cocaine cravings for individuals past acute withdrawal (46). The review by Echevarria et al (42) found studies demonstrating the potential of NAC to "reduce cravings, the desire to use cocaine, cocaine-cue viewing-time and cocaine-related spending" (2,22,43,44). As these studies either had small samples or had been carried out as open-label trials, their results are to be considered as preliminary, warranting further research (42).…”

Section: Cocaine and N-acetylcysteinementioning

confidence: 99%

N-acetylcysteine in the treatment of substance use disorders

Evren¹

2020

Dusunen Adam

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N-acetylcysteine (NAC) is an agent best known for its clinical efficacy in bronchopulmonary disorders due to its mucolytic properties, and in the treatment of acetaminophen overdose. Given the strong clinical evidence from animal studies of its critical role in regulating glutamatergic receptors, NAC has also been the subject of research related to several psychiatric disorders as a promising treatment approach. This editorial is a brief discussion of the characteristics of NAC and its place in substance use disorders and other psychiatric disorders.

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N-acetylcysteine for treating cocaine addiction – A systematic review

Cited by 45 publications

References 32 publications

Glutamate Transport: A New Bench to Bedside Mechanism for Treating Drug Abuse

Glutamate Transport: A New Bench to Bedside Mechanism for Treating Drug Abuse

Conduites addictives : faits cliniques

N-acetylcysteine in the treatment of substance use disorders

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