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N-Acetyl Cysteine May Aid in Treatment of Schizophrenia: Presented at ECNP

By Paula Moyer

VIENNA, AUSTRIA -- October 16, 2007 -- N-acetyl cysteine (NAC), an over-the-counter remedy used as a mucolytic agent for some pulmonary conditions, may be of benefit in the treatment of schizophrenia, according to a team of Australian investigators who presented their findings at the 20th European College of Neuropsychopharmacology (ECNP) Congress.

"The fact that NAC, a glutathione precursor, shows some promise may mean that glutathione deficiency is involved in the pathogenesis of schizophrenia," said principal investigator Michael Berk, MD, Professor of Psychiatry, University of Melbourne, Melbourne, Australia, presenting here on October 16.

Dr. Berk and his coinvestigators recruited 140 patients with schizophrenia to participate in a study involving NAC as a treatment adjunctive to their current antipsychotic therapy. Treatment effects were measured with the Clinical Global Impressions (CGI) Severity and Improvement scales and the Positive And Negative Syndrome Scale (PANSS).

Among these patients, 69 were in the investigative arm and 71 were in the placebo arm; 111 completed the 24-week trial, and 61 came to the postdiscontinuation visit. This attrition is typical of schizophrenia trials, Dr. Berk said.

By week 24, those on NAC had an average reduction of 0.4 in the CGI-Severity score, compared with an average decrease of 0.2 in the placebo arm. The PANSS negative subscale averaged 1.8 points less for those on NAC (P =.018). When treatment was withdrawn, however, those differences were erased. Interestingly, those on treatment had improvements in measurements of extrapyramidal symptoms, including the Simpson Angus score and the Barnes-Akathisia total. The three serious adverse events consisted of hospital admissions, were related to treatment nonadherence, and occurred in the placebo group.

"The study showed that NAC improves certain symptoms of schizophrenia, and therefore implicated glutathione deficiency in the pathogenesis," Dr. Berk concluded. He stressed the need for more studies with larger numbers of patients.


[Presentation title: N-acetyl Cysteine in Schizophrenia: A Double Blind Placebo Controlled Trial]

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