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Effects of N-acetylcysteine on substance use in bipolar disorder: a randomised placebo-controlled clinical trial

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Bernardo M, Dodd S, Gama CS, Copolov DL, Dean O, Kohlmann K, Jeavons S, Schapkaitz I, Anderson-Hunt M, Bush AI, Berk M. Effects of N-acetylcysteine on substance use in bipolar disorder: a randomised placebo-controlled clinical trial. Objective:

To evaluate the effect of N-acetylcysteine (NAC) on substance use in a double-blind, placebo-controlled trial of NAC in bipolar disorder. It is hypothesised that NAC will be superior to placebo for reducing scores on the Clinical Global Impressions scale for Substance Use (CGI-SU). Methods:

Participants were randomised to 6-months of treatment with 2 g/day NAC (n = 38) or placebo (n = 37). Substance use was assessed at baseline using the Habits instrument. Change in substance use was assessed at regular study visits using the CGI-SU. Results:

Amongst the 75 participants 78.7% drank alcohol (any frequency), 45.3% smoked tobacco and 92% consumer caffeine. Other substances were used by fewer than six participants. Caffeine use was significantly lower for NAC-treated participants compared with placebo at week 2 of treatment but not at other study visits. Conclusion:

NAC appeared to have little effect on substance use in this population. A larger study on a substance using population will be necessary to determine if NAC may be a useful treatment for substance use.
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Keywords: N-acetyl cysteine; alcohol; bipolar disorder; caffeine; clinical trial; smoking; substance use

Document Type: Research Article

Affiliations: 1: Department of Clinical and Biomedical Sciences: Barwon Health, The University of Melbourne, Geelong, Australia 2: Laboratório de Psiquiatria Molecular, Centro de Pesquisas, Hospital de Clínicas de Porto Alegre, Brazil 3: Mental Health Research Institute, Parkville, Australia

Publication date: October 1, 2009

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