Systematic review of N-acetylcysteine in the treatment of addictions

26 de março de 20144min0

Revista Brasileira de Psiquiatria

Print version ISSN 1516-4446

Rev. Bras. Psiquiatr., ahead of print Epub Mar 17, 2014 


Systematic review of N-acetylcysteine in the treatment of addictions

Elson Asevedo1, Ana C. Mendes2, Michael Berk34, Elisa Brietzke1

1Interdisciplinary Laboratory of Clinical Neurosciences (LINC), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo – SP – Brazil

2Santa Marcelina Hospital, São Paulo – SP – Brazil

3IMPACT Strategic Research Centre, Deakin University, School of Medicine and Barwon Health, Geelong – VIC – Australia

4Department of Psychiatry, Florey Institute of Neuroscience and Mental Health and Orygen Youth Health Research Centre, University of Melbourne, Parkville – VIC – Australia



To conduct the first systematic literature review of clinical trials of N-acetylcysteine (NAC) for the treatment of substance abuse disorders and addictive behaviors.


A search of the MEDLINE, Embase and PsycINFO databases was conducted. The inclusion criteria for the review were clinical trials that used NAC in the treatment of a disorder related to substance use and/or addictive behaviors, limited to texts in English, Spanish, or French. The selected studies were evaluated with respect to type of trial, sample size, diagnostic input, intervention, length of follow-up, outcome variables, and results.


Nine studies analyzing a total of 165 patients met the eligibility criteria and were included in qualitative analysis. These studies evaluated the role of NAC in cocaine dependence (three studies), cannabis dependence (two studies), nicotine dependence (two studies), methamphetamine addiction (one study), and pathological gambling (one study). Five of these trials were double-blind, randomized, and placebo-controlled.


The studies analyzed suggest a potential role for NAC in the treatment of addiction, especially of cocaine and cannabis dependence. These results are concordant with the hypothesis of the involvement of glutamatergic pathways in the pathophysiology of addiction.

Key words: Drug dependence; addictive behaviors; N-acetylcysteine; glutamatergic receptors; smoking



Sobre a UNIAD

A Unidade de Pesquisa em álcool e Drogas (UNIAD) foi fundada em 1994 pelo Prof. Dr. Ronaldo Laranjeira e John Dunn, recém-chegados da Inglaterra. A criação contou, na época, com o apoio do Departamento de Psiquiatria da UNIFESP. Inicialmente (1994-1996) funcionou dentro do Complexo Hospital São Paulo, com o objetivo de atender funcionários dependentes.


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