Efficacy and acceptability of adjunctive n-acetylcysteine for psychotic disorders: Systematic review and meta-analysis

IF 1.8 4区医学 Q3 CLINICAL NEUROLOGY Human Psychopharmacology: Clinical and Experimental Pub Date : 2023-09-15 DOI:10.1002/hup.2880

Qun Zhang, Ziping Liu, Ting Wang, Min Yu, Xiaoqian Li

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Abstract

Introduction

N-acetylcysteine (NAC) augmentation of antipsychotic medication has been studied in psychotic disorders but the results are inconsistent. This meta-analysis aimed to evaluate the efficacy and acceptability of NAC as an augmentation strategy for psychotic disorders.

Methods

PubMed, Web of Science, EMBASE, PsycINFO, Cochrane Library, and ClinicalTrials.gov were searched until the date of November 28, 2022. The inclusion criteria were randomized controlled trials (RCTs) comparing NAC and placebo in patients with psychotic disorders. The outcomes were the psychotic symptoms measured by the Positive and Negative Syndrome Scale (PANSS) and drop-out rates.

Results

A total of 594 patients from eight trials were included. The results showed that no difference was found in score changes of PANSS total, positive, negative, or general psychopathology scale scores between the NAC group and placebo group in both time points (≤24 weeks and >24 weeks). There was also no statistical difference in drop-out rates between the two groups.

Conclusion

For the moment, it is not appropriate to recommend NAC as an augmentation of antipsychotic medication to treat psychotic disorders in routine clinical practice.

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正乙酰半胱氨酸辅助治疗精神病的疗效和可接受性：系统回顾和荟萃分析。

导言：N-乙酰半胱氨酸（NAC）增强抗精神病药物治疗精神障碍的研究一直在进行，但结果并不一致。这项荟萃分析旨在评估 NAC 作为精神病性障碍药物增效策略的疗效和可接受性：方法：检索了 PubMed、Web of Science、EMBASE、PsycINFO、Cochrane Library 和 ClinicalTrials.gov，直至 2022 年 11 月 28 日。纳入标准是在精神病患者中比较 NAC 和安慰剂的随机对照试验 (RCT)。研究结果为通过阳性和阴性综合量表（PANSS）测量的精神病症状和辍学率：结果：共纳入了 8 项试验中的 594 名患者。结果显示，在两个时间点（≤24周和>24周），NAC组与安慰剂组在PANSS总分、阳性、阴性或一般精神病理量表得分的变化上没有差异。两组的辍学率也没有统计学差异：结论：就目前而言，在常规临床实践中推荐NAC作为抗精神病药物治疗精神障碍的辅助药物并不合适。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Human Psychopharmacology: Clinical and Experimental 医学-精神病学

CiteScore

4.10

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Human Psychopharmacology: Clinical and Experimental provides a forum for the evaluation of clinical and experimental research on both new and established psychotropic medicines. Experimental studies of other centrally active drugs, including herbal products, in clinical, social and psychological contexts, as well as clinical/scientific papers on drugs of abuse and drug dependency will also be considered. While the primary purpose of the Journal is to publish the results of clinical research, the results of animal studies relevant to human psychopharmacology are welcome. The following topics are of special interest to the editors and readers of the Journal: -All aspects of clinical psychopharmacology- Efficacy and safety studies of novel and standard psychotropic drugs- Studies of the adverse effects of psychotropic drugs- Effects of psychotropic drugs on normal physiological processes- Geriatric and paediatric psychopharmacology- Ethical and psychosocial aspects of drug use and misuse- Psychopharmacological aspects of sleep and chronobiology- Neuroimaging and psychoactive drugs- Phytopharmacology and psychoactive substances- Drug treatment of neurological disorders- Mechanisms of action of psychotropic drugs- Ethnopsychopharmacology- Pharmacogenetic aspects of mental illness and drug response- Psychometrics: psychopharmacological methods and experimental design