Meta-analysis of randomised controlled trials with N-acetylcysteine in the treatment of schizophrenia.

Abstract

OBJECTIVE:

There is accumulating evidence that adjunctive treatment with N-acetylcysteine may be effective for schizophrenia. This study aimed to conduct a comprehensive meta-analysis examining the efficacy of randomised control trials investigating N-acetylcysteine as an adjunct treatment for schizophrenia and the first to investigate cognition as an outcome.

METHODS:

We systematically reviewed Medline, EmCare, PsycINFO, Embase, CINAHL Complete, China Knowledge Resource Integrated Database and the Cochrane Clinical Trials online registry for randomised control trials of N-acetylcysteine for schizophrenia. We undertook pairwise meta-analyses of N-acetylcysteine vs placebo for psychosis symptoms and cognition.

RESULTS:

Seven studies, including n = 220 receiving N-acetylcysteine and n = 220 receiving placebo, met inclusion criteria for the pairwise meta-analyses. Positive and Negative Syndrome Scale negative and total scores were significantly improved in the N-acetylcysteine group after 24 weeks of treatment. The cognitive domain of working memory improved with N-acetylcysteine supplementation.

CONCLUSION:

Evidence supports the notion that N-acetylcysteine may be a useful adjunct to standard treatment for the improvement of schizophrenia symptoms, as well as the cognitive domain of working memory. Treatment effects were observed at the later time point (⩾24 weeks), suggesting that longer interventions are required for the success of N-acetylcysteine treatment.

• Authors: Caitlin Ob Yolland, Donal Hanratty, Erica Neill, Susan L Rossell, Michael Berk, Olivia M Dean, David J Castle, Eric J Tan, Andrea Phillipou, Anthony Wf Harris, Ana Rita Barreiros, Abigail Hansen, Dan Siskind
• Journal: The Australian and New Zealand journal of psychiatry (Aust N Z J Psychiatry) Vol. 54 Issue 5 Pg. 453-466 (05 2020) ISSN: 1440-1614 [Electronic] England
• PMID: 31826654 (Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Systematic Review)

Chemical References

• Acetylcysteine

Topics

• Acetylcysteine (therapeutic use)
• Cognition
• Humans
• Memory, Short-Term
• Psychotic Disorders
• Randomized Controlled Trials as Topic
• Schizophrenia (drug therapy)