N-acetylcysteine in psychiatry: current therapeutic evidence and potential mechanisms of action

Context: This study was a systematic review that aimed to extract published articles regarding oxidant and antioxidants status in opium addiction by searching in PubMed, Google Scholar engine, SID, and Magiran databases. Evidence Acquisition: Sixty-six published articles were investigated in this review, which were selected from studies among the Iranian society and other societies from 1976 to 2015. All articles published in different fields of descriptive-analytical, experimental, and interventional studies were considered. Results: Several studies have shown that with increased production of free radicals and reactive oxygen species (ROS), the enzymatic and non-enzymatic antioxidants such as glutathione (GSH) and glutathione peroxidase (GPx), superoxide dismutase (SOD), and catalase activities, and also the concentration of vitamins A, E, C and total antioxidant capacity (TAC) decrease in opium addiction. Increased atherogenic indexes such as Low density lipoprotein/high density lipoprotein (LDL/HDL) ratio and malondialdehyde (MDA) may contribute to the increased risk of cardiovascular disease. However, it has also increased other markers of oxidative stress including: isoprostanes, 8-oxoguanine and protein carbonyl. Conclusions: Oxidative stress increases in opium-addicted people. It seems that opium is capable of provoking oxidative stress and also, has harmful effects on lipid profile and antioxidant enzyme. Drug addicts were found to have antioxidant vitamin deficiency.

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“…•-in organisms through the scavenging mechanism (41). It has been postulated Int J High Risk Behav Addict.…”

Section: Glutathione Activity (Gsh)mentioning

confidence: 99%

Study of Oxidants and Antioxidants in Addicts

Karajibani

Montazerifar

Feizabad

2016

Int J High Risk Behav Addict

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“…Acetylcysteine is transformed to cysteine and cysteine combines with glutamate thereby forming up glutathione. GSH is a potent antioxidant playing a role in immune system [1,3]. NAC increases cysteine and glutathione levels in glial cells [4].…”

Section: As An Antioxidantmentioning

confidence: 99%

“…Mechanism of action of NAC may be explained with inflammatory cytokines production in psychiatric patients undergoing NAC treatment. This may be directly associated with inflammatory pathway or oxidative process with inflammation [1].…”

Section: As An Antioxidantmentioning

confidence: 99%

“…Firstly NAC, later on TTM was detailed and NAC administration would be evaluated in TTM. N-acetylcysteine: NAC, glutathione (GSH-y-glutamyl) as an antioxidant has been used in the treatment of paracetemol intoxication over 30 years [1]. On the other hand, it is commonly administrated in cases with chronic obstructive pulmonary disease as a mucolytic agent [2].…”

Section: Introductionmentioning

confidence: 99%

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N-acetylcysteine in trichotillomania as an alternative treatment option

Erşan¹

2013

CMJ

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We aimed to examine trichotillomania (TTM), a rarely seen disorder, and N-acetylcysteine (NAC), an agent used as a treatment option, in the light of literature in the present study. Trichotillomania is the compulsive urge to pull out one's own hair persistently and leading to noticeable hair loss. Contrary to what is expected, it is a more frequently detected disorder characterized by compulsive hair pull-outs and of great importance not only due to physical appearance but also due to its associated psychosocial problems. Metabolic functions of N-acetylcysteine are effective either as antioxidant (forming up glutathione which is an endogenous antioxidant) or as glutamatergic agent. Due to these effects, N-acetylcysteine was administrated in as oxidative stress related schizophrenia and bipolar disorders as well as trichotillomania characterized by compulsive symptoms and in eating nail. Administration of N-acetylcysteine in cases with psychiatric disorders was reported in clinical researches such as case report and open label studies. In the literature, the efficiency of N-acetylcysteine in the treatment of trichotillomania was demonstrated in 3 studies as case report, double blind and placebo controlled researches. N-acetylcysteine may be a promising and ideal treatment option in the mono or combined treatment of diseases such as trichotillomania due to its efficiency, and cost affectivity, but it also does not lead to adverse effects. Keywords: Trichotillomania, N-acetylcysteine, glutamate, antioxidants ÖzetBu yazıda, günlük pratikte sık karşılaşılan bir bozukluk olmayan trikotillomani (TTM) ve tedavisinde kullanılan N-asetilsistein'in (NAC) literatür ışığında gözden geçirilmesi amaçlanmıştır. Trikotillomani kişinin tekrarlayıcı olarak ve belirgin saçsız alanlar oluşturacak şekilde saçlarını yolmasıdır. Trikotillomani sanıldığının aksine daha sık görülen, kompulsif saç yolmalarla karakterize sadece fiziksel görünüm açısından değil yaşattığı psikososyal sorunlar nedeniyle önemli bir ruhsal bozukluktur. N-Asetilsistein metabolik fonksiyonlarını, ya antioksidan (endojen antioksidan olan glutatyon oluşturarak) ya da glutamaterjik düzenleyici olarak gösterir. Bu etkileri nedeniyle N-Asetilsistein; oksidatif stres ile ilişkili şizofreni, bipolar gibi bozukluklarda, ayrıca kompulsif belirtiler ile karakterize trikotillomani, tırnak yeme gibi bozukluklarda kullanılmıştır. N-Asetilsistein'in psikiyatrik hastalıklarda kullanımı; olgu sunumu, açık-etiketli pilot çalışmalar ve çalışmalar gibi klinik araştırmalarla bildirilmiştir. Literatürde NAsetilsistein'in trikotillomani tedavisinde etkinliği; 3 çalışmada olgu sunumu ve çift-kör, plasebokontrollü araştırmalar ile gösterilmiştir. N-Asetilsistein gerek etkinliği, gerek ucuz olması ve yan etkilere yol açmaması nedeniyle; Trikotillomani gibi hastalıkların tekli ya da kombine tedavisinde umut verici ve ideal bir tedavi seçeneği olabilir.

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“…Para revisões sistemáticas recentemente publicadas com descrições mais detalhadas dos estudos, sugerimos os trabalhos de Grande et al 27 , em relação a neurotrofinas, de Goldstein et al 16 e de Drexhage et al 28 , para inflamação. Há revisões que abordam em profundidade a relação entre biologia oxidativa e transtorno bipolar 2,29,30 .…”

Section: Métodounclassified

Marcadores periféricos e a fisiopatologia do transtorno bipolar

Magalhães¹,

Fries²,

Kapczinski³

2012

Rev. psiquiatr. clín.

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Introdução: O entendimento da fisiopatologia do transtorno bipolar vem tendo avanços consistentes nos últimos anos. Um enfoque na relação entre carga alostática e alterações sistêmicas vem tomando corpo, com o objetivo de se entender a frequente progressão da doença. Proeminentes entre os mediadores periféricos têm sido as moléculas que poderiam ser amplamente agrupadas em neurotrofinas, marcadores de estresse oxidativo e marcadores inflamatórios. Objetivo: Descrever achados recentes em relação à fisiopatologia sistêmica do transtorno bipolar, com enfoque especial em estudos brasileiros, tentando articular uma visão coerente do conhecimento atual do campo. Método: Revisão narrativa da literatura relacionada a neurotrofinas, estresse oxidativo e marcadores inflamatórios no transtorno bipolar. Resultados: Diversas fontes de evidência, provenientes tanto de estudos pré-clínicos quanto clínicos, revelam consistentemente alterações sistêmicas no transtorno bipolar. Os achados são especialmente robustos em pacientes com múltiplos episódios. Nesses, alterações relacionadas a episódios de mania e depressão são notáveis em neurotrofinas e dano oxidativo a lipídeos. Um número menor de estudos mostra alterações no sistema imune, em particular estados pró-inflamatórios. Conclusão: Alterações sistêmicas que correlacionam o transtorno bipolar a comorbidade clínica, disfunção cognitiva, incapacidade e mortalidade precoce começam a ser traçadas. Estudos envolvendo desenhos longitudinais, amostras populacionais e ensaios clínicos envolvendo marcadores periféricos devem ser incorporados no futuro próximo e reforçar a validade de uma noção de envolvimento multissistêmico no transtorno bipolar.Magalhães PVS, et al. / Rev Psiq Clín. 2012;39(2):60-7 Palavras-chave: Transtorno bipolar, inflamação, estresse oxidativo, neurotrofinas, fator neurotrófico derivado do cérebro, fisiopatologia, biomarcadores. ABSTRACT Introduction:The understanding of the pathophysiology of bipolar disorder has steadily advanced in the past few years. Thereby, a focus on allostatic load and systemic changes has appeared, with the aim to understand illness progression. Amongst the peripheral markers, molecules that can be widely classified into neurotrophins, oxidadive stress markers, and inflammation markers have been elevated. Objective: To describe recent findings regarding the systemic pathophysiology of bipolar disorder, with a special focus on Brazilian studies and to create a coherent view of the current knowledge in the field. Method: Narrative review of the literature regarding neurotrophins, oxidative stress, and inflammatory markers in bipolar disorder. Results: A diverse body of evidence, based on both pre-clinical and clinical studies, reveals consistent systemic changes in bipolar disorder. The findings are particularly robust in patients after multiple episodes. Thereby, remarkable changes related to manic and depressive episodes were found in neurotrophins and oxidative damage to lipids. Regarding to immune system alterations, in particular pro...

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N-acetylcysteine in psychiatry: current therapeutic evidence and potential mechanisms of action

Cited by 415 publications

References 83 publications

Study of Oxidants and Antioxidants in Addicts

Study of Oxidants and Antioxidants in Addicts

N-acetylcysteine in trichotillomania as an alternative treatment option

Marcadores periféricos e a fisiopatologia do transtorno bipolar

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