2025
N-acetylcysteine (NAC) supplementation improves dyspnea and may normalize von Willebrand plasma levels in gynecologic patients with Post-Acute-COVID-Sequela (PASC)/Long COVID
Bellone S, Siegel E, Santin A. N-acetylcysteine (NAC) supplementation improves dyspnea and may normalize von Willebrand plasma levels in gynecologic patients with Post-Acute-COVID-Sequela (PASC)/Long COVID. Gynecologic Oncology Reports 2025, 57: 101682. PMID: 39944180, PMCID: PMC11814706, DOI: 10.1016/j.gore.2025.101682.Peer-Reviewed Original ResearchVon Willebrand factorN-acetylcysteinePost-acute sequelae of COVID-19Gynecologic patientsVWF levelsLevels of clotting factorsVon Willebrand factor levelsOral N-acetylcysteineProspective Randomized StudyShortness of breathGynecologic oncology clinicChronically elevated levelsLong COVIDCOVID-19 patientsN-acetylcysteine supplementationSequelae of COVID-19Microvascular inflammationSubjective improvementThrombotic complicationsRandomized studyRed blood cellsControl patientsPrecursor of glutathionePlasma levelsCancer patientsN-acetylcysteine modulates markers of oxidation, inflammation and infection in tuberculosis
Mapamba D, Sabi I, Lalashowi J, Sauli E, Buza J, Olomi W, Mtafya B, Kibona M, Bakuli A, Rachow A, Velen K, Hoelscher M, Ntinginya N, Charalambous S, Churchyard G, Wallis R, consortium T. N-acetylcysteine modulates markers of oxidation, inflammation and infection in tuberculosis. Journal Of Infection 2025, 90: 106379. PMID: 39756697, DOI: 10.1016/j.jinf.2024.106379.Peer-Reviewed Original ResearchAdjunctive N-acetylcysteineN-acetylcysteinePulmonary tuberculosisEx vivo whole blood cultureAffecting IL-10Effect of N-acetylcysteineFar-advanced pulmonary tuberculosisRecovery of lung functionN-acetylcysteine treatmentWhole blood culturesHost-directed therapiesPost-tuberculosis lung diseaseReduction of oxidative stressClearance of MtbAnti-inflammatory effectsBiomarkers of oxidationBlood culturesSecondary endpointsTotal glutathionePreclinical modelsClinical outcomesMtb burdenMonth 1Healthy volunteersIL-10
2024
Adjunctive N-Acetylcysteine and Lung Function in Pulmonary Tuberculosis.
Wallis R, Sabi I, Lalashowi J, Bakuli A, Mapamba D, Olomi W, Siyame E, Ngaraguza B, Chimbe O, Charalambous S, Rachow A, Ivanova O, Zurba L, Myombe B, Kunambi R, Hoelscher M, Ntinginya N, Churchyard G. Adjunctive N-Acetylcysteine and Lung Function in Pulmonary Tuberculosis. NEJM Evidence 2024, 3: evidoa2300332. PMID: 39189858, DOI: 10.1056/evidoa2300332.Peer-Reviewed Original ResearchConceptsWhole blood glutathione levelsLung functionN-acetylcysteinePulmonary tuberculosisCulture conversionSecondary outcomesGlutathione levelsEffect of N-acetylcysteineTuberculosis treatment outcomesOutcome of lung functionOral N-acetylcysteineRecovery of lung functionAdjunctive N-acetylcysteineAssociated with improved recoveryN-acetylcysteine treatmentPermanent lung injuryFar-advanced tuberculosisSputum cultureStandard therapyNAC administrationAdverse eventsLung injuryGlobal health concernCohort studyClinical evaluationCombined Use of Guanfacine and N-Acetylcysteine for the Treatment of Cognitive Deficits After Traumatic Brain Injury
Khasnavis S, Belliveau T, Arnsten A, Fesharaki-Zadeh A. Combined Use of Guanfacine and N-Acetylcysteine for the Treatment of Cognitive Deficits After Traumatic Brain Injury. Neurotrauma Reports 2024, 5: 226-231. PMID: 38524728, PMCID: PMC10960163, DOI: 10.1089/neur.2023.0124.Peer-Reviewed Original ResearchTreatment of cognitive deficitsTraumatic brain injuryExecutive functionCognitive deficitsTraumatic brain injury clinicEfficacy of guanfacinePre-frontal cortexBrain injuryTreat traumatic brain injuryBehavioral therapyNeuropsychological testsCognitive symptomsCognitive changesPlacebo-controlled trialProcessing speedGuanfacineCortical functionOpen-label useApproved medicationsPersonsPost-treatmentDeficitsTraumatizationN-acetylcysteineMTBI
2023
Comprehensive transcriptomic analysis and meta-analysis identify therapeutic effects of N-acetylcysteine in nonalcoholic fatty liver disease
Yang K, Kim H, Shim Y, Ryu T, Kim C. Comprehensive transcriptomic analysis and meta-analysis identify therapeutic effects of N-acetylcysteine in nonalcoholic fatty liver disease. Frontiers In Pharmacology 2023, 14: 1186582. PMID: 37256235, PMCID: PMC10225598, DOI: 10.3389/fphar.2023.1186582.Peer-Reviewed Original ResearchNonalcoholic fatty liver diseaseEffect of N-acetylcysteineN-acetylcysteineFatty liver diseaseLiver diseaseEfficacy of N-acetylcysteineProtective effect of N-acetylcysteineTherapeutic potentialPrevalence of nonalcoholic fatty liver diseaseTherapeutic effect of N-acetylcysteineMeta-analysisLevels compared to controlsN-acetylcysteine treatmentAssociated with NAFLD developmentSystematic Review CentrePreclinical studiesClinical trialsLiver injuryWeb of ScienceGlucose intoleranceTherapeutic effectGlobal health issueCochrane LibraryEgger's testHepatic steatosisClinical experience with the α2A-adrenoceptor agonist, guanfacine, and N-acetylcysteine for the treatment of cognitive deficits in “Long-COVID19”
Fesharaki-Zadeh A, Lowe N, Arnsten A. Clinical experience with the α2A-adrenoceptor agonist, guanfacine, and N-acetylcysteine for the treatment of cognitive deficits in “Long-COVID19”. Neuroimmunology Reports 2023, 3: 100154. PMCID: PMC9691274, DOI: 10.1016/j.nerep.2022.100154.Peer-Reviewed Original ResearchN-acetylcysteineCognitive deficitsΑ2A-adrenoceptor agonistsPrefrontal cortexCOVID19 infectionPlacebo-controlled trialOpen-label treatmentCommon side effectsExecutive functionPFC connectionsBrain fogAcid blockadeLabel treatmentHypotensive episodesGuanfacine treatmentNMDA receptorsPatient brieflySide effectsClinical experienceGuanfacineCognitive impairmentPatientsPrefrontal connectivityDemonstrate efficacyPrefrontal function
2022
The Potential of N-acetyl Cysteine in Behavioral Addictions and Related Compulsive and Impulsive Behaviors and Disorders: a Scoping Review
Greenberg N, Farhadi F, Kazer B, Potenza M, Angarita G. The Potential of N-acetyl Cysteine in Behavioral Addictions and Related Compulsive and Impulsive Behaviors and Disorders: a Scoping Review. Current Addiction Reports 2022, 9: 660-670. PMID: 38362235, PMCID: PMC10868722, DOI: 10.1007/s40429-022-00446-3.Peer-Reviewed Original ResearchN-acetylcysteineSelf-injurious behaviorEffectiveness of NACEfficacy of NACSmall open-label trialsUse of NACCompulsive sexual behaviorOpen-label trialRepetitive self-injurious behaviorSexual behaviorCompulsive behaviorsGambling disorderGlutamate dysregulationBehavioral addictionsCase reportClinical trialsPreclinical studiesGlutamate homeostasisAcetyl cysteineDisordersMore studiesScoping ReviewCompulsive featuresAddictionImpulsive behaviorMechanistic Effects and Use of N-acetylcysteine in Substance Use Disorders
Greenberg N, Farhadi F, Kazer B, Potenza M, Angarita G. Mechanistic Effects and Use of N-acetylcysteine in Substance Use Disorders. Current Behavioral Neuroscience Reports 2022, 9: 124-143. DOI: 10.1007/s40473-022-00250-3.Peer-Reviewed Original ResearchSubstance use disordersN-acetylcysteineUse disordersEfficacy of NACTreatment of SUDsGlial glutamate transporter-1Glutamate transporter 1Drug-seeking behaviorCue-induced reinstatementNAC useAdjunctive useClinical studiesGlutamate homeostasisGlutamate signalingNeurobiological effectsClinical approachRelapse behaviorSubcortical regionsSynaptic plasticityFunctional connectivity networksPrefrontal cortexBehavioral interventionsTransporter 1Oxidative stressImpulsive behavior
2020
Pharmacological and behavioral treatment for trichotillomania: An updated systematic review with meta‐analysis
Farhat LC, Olfson E, Nasir M, Levine JLS, Li F, Miguel EC, Bloch MH. Pharmacological and behavioral treatment for trichotillomania: An updated systematic review with meta‐analysis. Depression And Anxiety 2020, 37: 715-727. PMID: 32390221, DOI: 10.1002/da.23028.Peer-Reviewed Original ResearchConceptsClinical trialsSingle randomized clinical trialTTM symptomsFirst-line medicationRandomized clinical trialsStrong evidence baseLarge treatment effectsHair pulling disorderEffective medicationsAvailable agentsPharmacological agentsAdditional trialsDrug AdministrationPsychiatric conditionsSystematic reviewN-acetylcysteineBehavioral treatmentBehavioral therapyEvidence baseTrichotillomaniaTrialsRelative efficacyTreatment effectsMedicationsSymptoms
2019
N-Acetylcysteine for Pediatric Obsessive-Compulsive Disorder: A Small Pilot Study
Li F, Welling MC, Johnson JA, Coughlin C, Mulqueen J, Jakubovski E, Coury S, Landeros-Weisenberger A, Bloch MH. N-Acetylcysteine for Pediatric Obsessive-Compulsive Disorder: A Small Pilot Study. Journal Of Child And Adolescent Psychopharmacology 2019, 30: 32-37. PMID: 31800306, PMCID: PMC7133418, DOI: 10.1089/cap.2019.0041.Peer-Reviewed Original ResearchConceptsCY-BOCS total scoreN-acetylcysteineYale-Brown ObsessiveTotal scorePlacebo groupNAC groupStudy populationBenefit of NACPlacebo-controlled clinical trialSymptom severityEffect of NACMild adverse eventsOCD symptom severityLarger study populationPediatric obsessive-compulsive disorderSmall pilot studyChildren's Yale-Brown ObsessiveStudy medicationAdverse eventsPrimary outcomeGlutamate dysfunctionObsessive-compulsive disorderWeek 12Future trialsNAC treatmentChapter 13 Trauma and Addiction—How to Treat Co-occurring PTSD and Substance Use Disorders
Vojvoda D, Petrakis I. Chapter 13 Trauma and Addiction—How to Treat Co-occurring PTSD and Substance Use Disorders. 2019, 189-196. DOI: 10.1016/b978-0-323-54856-4.00013-4.Peer-Reviewed Original ResearchSubstance use disordersAlcohol use disorderPosttraumatic stress disorderComorbid substance use disorderPTSD symptomsCo-occurring posttraumatic stress disorderRandomized clinical studyWorse clinical outcomesTreatment of patientsSeverity of AUDSeverity of symptomsCo-occurring disordersReduction of severityRecent pharmacological advancesAnticonvulsant topiramateClinical outcomesPharmacological treatmentPTSD comorbidityClinical studiesPharmacological advancesInconstant effectsMedicationsUse disordersAlcohol consumptionN-acetylcysteine9: Randomized controlled trial of n-acetylcysteine to prevent adverse neonatal outcome in pregnancies with intra-amniotic infection/inflammation
Buhimschi C, Bahtiyar M, Abdelghany O, Schneider L, Abdel-Raqez S, Dulay A, Lipkind H, Lopez E, Zhao G, Rogers L, Bhandari V, Buhimschi I. 9: Randomized controlled trial of n-acetylcysteine to prevent adverse neonatal outcome in pregnancies with intra-amniotic infection/inflammation. American Journal Of Obstetrics And Gynecology 2019, 220: s9. DOI: 10.1016/j.ajog.2018.11.011.Peer-Reviewed Original Research
2017
Randomized, Double-Blind, Placebo-Controlled Trial of N-Acetylcysteine Augmentation for Treatment-Resistant Obsessive-Compulsive Disorder.
Costa DLC, Diniz JB, Requena G, Joaquim MA, Pittenger C, Bloch MH, Miguel EC, Shavitt RG. Randomized, Double-Blind, Placebo-Controlled Trial of N-Acetylcysteine Augmentation for Treatment-Resistant Obsessive-Compulsive Disorder. The Journal Of Clinical Psychiatry 2017, 78: e766-e773. PMID: 28617566, DOI: 10.4088/jcp.16m11101.Peer-Reviewed Original ResearchMeSH KeywordsAcetylcysteineAdolescentAdultAgedAnxiety DisordersComorbidityDepressive DisorderDouble-Blind MethodDrug ResistanceDrug Therapy, CombinationFemaleHumansMaleMiddle AgedObsessive-Compulsive DisorderPsychiatric Status Rating ScalesPsychometricsSelective Serotonin Reuptake InhibitorsYoung AdultConceptsTreatment-resistant obsessive-compulsive disorderObsessive-compulsive disorderY-BOCS scoresN-acetylcysteineNAC groupYale-Brown Obsessive Compulsive Scale scoresTreatment-resistant OCD patientsBaseline Y-BOCS scoresTreatment-Resistant ObsessivePrimary outcome measureAnxiety symptomsDSM-IV criteriaSymptom dimensionsCompulsive Scale scoresSpecific OCD symptom dimensionsOCD symptom dimensionsAntioxidant medicationsAbdominal painPlacebo groupGlutamate modulatorsSecondary outcomesTertiary hospitalOutpatient clinicSeverity scoreWeek 16
2016
N-Acetylcysteine in the Treatment of Pediatric Tourette Syndrome: Randomized, Double-Blind, Placebo-Controlled Add-On Trial
Bloch MH, Panza KE, Yaffa A, Alvarenga PG, Jakubovski E, Mulqueen JM, Landeros-Weisenberger A, Leckman JF. N-Acetylcysteine in the Treatment of Pediatric Tourette Syndrome: Randomized, Double-Blind, Placebo-Controlled Add-On Trial. Journal Of Child And Adolescent Psychopharmacology 2016, 26: 327-334. PMID: 27027204, PMCID: PMC6445198, DOI: 10.1089/cap.2015.0109.Peer-Reviewed Original ResearchConceptsBenefit of NACEfficacy of NACYale Global Tic Severity ScaleAttention-deficit/hyperactivity disorderObsessive-compulsive disorderTourette syndromeN-acetylcysteineObsessive-compulsive spectrum disordersSide effectsRecent placebo-controlled trialPediatric Tourette syndromePlacebo-controlled trialCurrent pharmacological treatmentsTreatment of ticsTotal tic scoreSeverity of ticsSubstantial side effectsTic Severity ScaleYears of ageMinimal side effectsPediatric TSPrimary outcomeSecondary outcomesGlutamatergic systemPharmacological treatment
2015
N-acetylcysteine decreased nicotine reward-like properties and withdrawal in mice
Bowers M, Jackson A, Maldoon P, Damaj M. N-acetylcysteine decreased nicotine reward-like properties and withdrawal in mice. Psychopharmacology 2015, 233: 995-1003. PMID: 26676982, PMCID: PMC4819399, DOI: 10.1007/s00213-015-4179-4.Peer-Reviewed Original ResearchConceptsAnxiety-like behaviorN-acetylcysteineContinuous nicotineNicotine place conditioningSaline-treated miceNicotine-treated miceMale ICR miceSomatic withdrawal signsHigh clinical utilityPlace aversion paradigmPlace preference paradigmReward-like propertiesN-acetylcysteine pretreatmentSpontaneous withdrawalExtrasynaptic glutamateWithdrawal signsICR miceNicotine rewardSmoking ratesSomatic signsClinical utilityNicotine dependenceFood CPPNicotine CPPObjectivesThe aimP.4.d.006 Serotonin reuptake inhibitor augmentation with n-acetylcysteine in treatment resistant ocd: a double-blind randomized controlled trial
Costa D, Diniz J, Joaquim M, Acciarito A, Rodrigues B, Oda E, Requena G, Miguel E, Shavitt R. P.4.d.006 Serotonin reuptake inhibitor augmentation with n-acetylcysteine in treatment resistant ocd: a double-blind randomized controlled trial. European Neuropsychopharmacology 2015, 25: s570. DOI: 10.1016/s0924-977x(15)30798-7.Peer-Reviewed Original ResearchN-acetylcysteineTrialsLONG‐TERM OUTCOME IN PEDIATRIC TRICHOTILLOMANIA
Schumer MC, Panza KE, Mulqueen JM, Jakubovski E, Bloch MH. LONG‐TERM OUTCOME IN PEDIATRIC TRICHOTILLOMANIA. Depression And Anxiety 2015, 32: 737-743. PMID: 26139231, PMCID: PMC4591183, DOI: 10.1002/da.22390.Peer-Reviewed Original ResearchConceptsPoor long-term prognosisLong-term prognosisLong-term outcomesN-acetylcysteineDepressive symptomsPediatric trichotillomaniaTrichotillomania symptomsOlder ageAdequate symptom reliefPlacebo-controlled trialAnxiety symptomsPredictors of outcomePrevious cross-sectional studiesRisk of depressionCross-sectional studyPrimary outcomeSymptom reliefAcute phaseClinical assessmentTreatment utilizationBaseline evaluationSecondary measuresBaseline assessmentSymptomsBehavioral treatment417: Neonates exposed to inflammation in-utero carry a spectrum of potent inflammatory and oxidant circulating molecules, that can be potentially reversed by N-acetylcysteine (NAC) and ethylpyruvate (EP)
Buhimschi I, Li M, Zhao G, Bahtiyar M, Cackovic M, Madri J, Bhandari V, Buhimschi C. 417: Neonates exposed to inflammation in-utero carry a spectrum of potent inflammatory and oxidant circulating molecules, that can be potentially reversed by N-acetylcysteine (NAC) and ethylpyruvate (EP). American Journal Of Obstetrics And Gynecology 2015, 212: s217. DOI: 10.1016/j.ajog.2014.10.463.Peer-Reviewed Original Research
2014
Long-term treatment with oral N-acetylcysteine: Affects lung function but not sputum inflammation in cystic fibrosis subjects. A phase II randomized placebo-controlled trial
Conrad C, Lymp J, Thompson V, Dunn C, Davies Z, Chatfield B, Nichols D, Clancy J, Vender R, Egan M, Quittell L, Michelson P, Antony V, Spahr J, Rubenstein R, Moss R, Herzenberg L, Goss C, Tirouvanziam R. Long-term treatment with oral N-acetylcysteine: Affects lung function but not sputum inflammation in cystic fibrosis subjects. A phase II randomized placebo-controlled trial. Journal Of Cystic Fibrosis 2014, 14: 219-227. PMID: 25228446, DOI: 10.1016/j.jcf.2014.08.008.Peer-Reviewed Original ResearchConceptsOral N-acetylcysteineLung functionN-acetylcysteineHNE activityHuman neutrophil elastase (HNE) activityDouble-blind proofPlacebo-controlled trialNeutrophil elastase activityPotential of NACLong-term treatmentLung function measuresCystic fibrosis subjectsPlacebo recipientsNeutrophilic inflammationPlacebo groupPulmonary hypertensionClinical outcomesNAC groupCF subjectsCF airwaysSystemic glutathioneNAC recipientsFunction measuresElastase activityInflammation
2013
Studies of the metabotropic glutamate receptor 5 radioligand [11C]ABP688 with N‐acetylcysteine challenge in rhesus monkeys
Sandiego CM, Nabulsi N, Lin S, Labaree D, Najafzadeh S, Huang Y, Cosgrove K, Carson RE. Studies of the metabotropic glutamate receptor 5 radioligand [11C]ABP688 with N‐acetylcysteine challenge in rhesus monkeys. Synapse 2013, 67: 489-501. PMID: 23424090, PMCID: PMC3710146, DOI: 10.1002/syn.21656.Peer-Reviewed Original ResearchConceptsN-acetylcysteineRhesus monkeysCerebellum gray matterMetabotropic glutamate receptor 5N-acetylcysteine challengeBaboon studiesGlutamate receptor 5Non-displaceable binding potentialHigh intersubject variabilityReference regionRecent pilot studySignificant global decreaseGlutamate transmissionNAC doseEndogenous glutamatePsychiatric illnessReceptor 5Gray matterAllosteric antagonistsPilot studyReceptor bindingIntersubject variabilitySame dayDoseMonkeys
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