Towards stage specific treatments: Effects of duration of illness on therapeutic response to adjunctive treatment with N-acetyl cysteine in schizophrenia

Rapado-Castro, Marta; Berk, Michael; Venugopal, Kamalesh; Bush, Ashley I.; Dodd, Seetal; Dean, Olivia

doi:10.1016/j.pnpbp.2014.10.002

Cited by 32 publications

(18 citation statements)

References 54 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although the literature provides evidence of a similar cognitive profile across psychotic disorders (Martinez-Aran and Vieta, 2015), particularly related to woking memory (Kim et al, 2015), the characteristics of the sample (stablished/chronic schizophrenia or bipolar disorder with psychotic features) together with the small sample size, prevented us from exploring the differences between early stages or diagnostic subgroups in detail. As we have previously suggested, NAC may possibly be more effective on the later stages (Rapado-Castro et al, 2015). Although it is well established that cognitive dysfunction is one of the characteristics of psychosis, the evolution and course of the cognitive deficits is still controversial.…”

Section: Improvements In Working Memory Have Also Been Observed In Stmentioning

confidence: 89%

Cognitive effects of adjunctive N-acetyl cysteine in psychosis

et al. 2016

View full text Add to dashboard Cite

show abstract

Section: Improvements In Working Memory Have Also Been Observed In Stmentioning

confidence: 89%

Cognitive effects of adjunctive N-acetyl cysteine in psychosis

et al. 2016

View full text Add to dashboard Cite

show abstract

“…[ 137,138 ] In several clinical trials, NAC as an adjunctive treatment improved both positive and negative symptoms of SCZ on the Positive and Negative Syndrome Scale (PANSS) subscale, as well as cognitive functions and auditory processing. [ 139–143 ] Moreover, NAC add‐on treatment improved white matter integrity in early psychosis patients. [ 144 ] Overall, these chemicals that enhance mitochondrial function are safe and well tolerated as a means of preventive or adjuvant treatment of SCZ, though more studies in larger cohorts are needed to further validate their efficacy and determine an optimal treatment strategy.…”

Section: Mitochondrial Function As a Potential Therapeutic Target Formentioning

confidence: 99%

Mitochondrial Dysfunction in Schizophrenia

Chung

2020

BioEssays

View full text Add to dashboard Cite

Schizophrenia (SCZ) is a severe neurodevelopmental disorder affecting 1% of populations worldwide with a grave disability and socioeconomic burden. Current antipsychotic medications are effective treatments for positive symptoms, but poorly address negative symptoms and cognitive symptoms, warranting the development of better treatment options. Further understanding of SCZ pathogenesis is critical in these endeavors. Accumulating evidence has pointed to the role of mitochondria and metabolic dysregulation in SCZ pathogenesis. This review critically summarizes recent studies associating a compromised mitochondrial function with people with SCZ, including postmortem studies, imaging studies, genetic studies, and induced pluripotent stem cell studies. This review also discusses animal models with mitochondrial dysfunction resulting in SCZ-relevant neurobehavioral abnormalities, as well as restoration of mitochondrial function as potential therapeutic targets. Further understanding of mitochondrial dysfunction in SCZ may open the door to develop novel therapeutic strategies that can address the symptoms that cannot be adequately addressed by current antipsychotics alone.

show abstract

“…Additional analysis25 has proposed the potential for stage-specific employment of NAC. Data from Berk and colleagues21 was stratified by duration of illness, showing that patients with schizophrenia of 20 or more years' duration had lower scores in all PANSS scores with significant differences reported for the total and PANSS positive scores.…”

Section: Discussionmentioning

confidence: 99%

Recycling N-acetylcysteine: A review of evidence for adjunctive therapy in schizophrenia

Willborn¹,

Hall²,

Fuller³

2019

Mental Health Clinician

View full text Add to dashboard Cite

Introduction All symptoms in schizophrenia may impact functioning. Although Food and Drug Administration-approved medications typically benefit positive symptoms, negative symptoms are generally refractory to medication interventions. N-acetylcysteine's (NAC) influence on glutamatergic neurotransmission has been established. An emerging body of research has attempted to correlate this action with reduction in symptom severity, evaluating response in positive, negative, and cognitive symptom domains. Methods A literature review was performed to analyze available data on NAC intervention and improvement in the positive, negative, and cognitive symptom domains in patients with schizophrenia. Quality of evidence was systematically assessed to determine level of certainty in results. Results Three randomized controlled trials were identified. Across studies, negative symptoms decreased more with NAC compared to placebo; ranging between 11.9% and 24.1%. The assessment determined a low level of certainty regarding benefit of NAC on negative and cognitive symptoms and moderate certainty for NAC regarding findings of side effects and lack of benefit on positive symptoms. Discussion Consistent reporting of benefit in negative symptoms is found across studies of NAC intervention. These improvements are notable for symptoms that have generally remained refractory to medication intervention. Inconsistent benefit was reported in positive and cognitive symptoms. GRADE (grading of recommendations assessment, development and evaluation) assessment of current evidence indicates a low certainty of benefit for negative symptoms with standard use of NAC in patients with schizophrenia. However, a trial of this low-risk intervention may be warranted in patients with resistant negative symptoms and subsequent impaired functioning despite appropriate antipsychotic therapy as they may experience additional benefit in this symptom domain.

show abstract

Towards stage specific treatments: Effects of duration of illness on therapeutic response to adjunctive treatment with N-acetyl cysteine in schizophrenia

Cited by 32 publications

References 54 publications

Cognitive effects of adjunctive N-acetyl cysteine in psychosis

Cognitive effects of adjunctive N-acetyl cysteine in psychosis

Mitochondrial Dysfunction in Schizophrenia

Recycling N-acetylcysteine: A review of evidence for adjunctive therapy in schizophrenia

Contact Info

Product

Resources

About