N-Acetylcysteine (NAC) in Schizophrenia and Bipolar Disorder- Prof Michael Berk

Posted on December 15, 2016

Professor Michael Berk is currently an NHMRC Senior Principal Research Fellow and is Alfred Deakin Chair of Psychiatry at Deakin University and Barwon Health, where he heads the IMPACT Strategic Research Centre. He also is an Honorary Professorial Research Fellow in the Department of Psychiatry, the Florey Institute for Neuroscience and Mental Health and Orygen Youth Health at Melbourne University, as well as in the School of Public Health and Preventive Medicine at Monash University. His major interests are in the discovery and implementation of novel therapies, and risk factors and prevention of psychiatric disorders.

Take home messages

  1. NAC showed a statistically significant reduction of negative symptoms in Schizophrenia but no effect on positive symptoms. N-acetyl cysteine treatment also was associated with an improvement in akathisia.
  2. NAC demonstrated large effect sizes across the range of Bipolar symptoms; from depression, to functioning, to quality of life etc.
  3. In the maintenance study, There were no significant between-group differences in recurrence or symptomatic outcomes during the maintenance phase of the trial; however, these findings may be confounded by limitations.
  4. In another study, it was revealed that NAC was suggestive of producing higher rates of remission for Mania, compared to a placebo.
  5. NAC may be useful as an adjunctive treatment in Major Depression in Bipolar Disorder
References:
  1. Berk, M., Copolov, D., Dean, O., Lu, K., Jeavons, S., Schapkaitz, I., … & Ording-Jespersen, S. (2008). N-acetyl cysteine as a glutathione precursor for schizophrenia—a double-blind, randomized, placebo-controlled trial. Biological psychiatry, 64(5), 361-368.
  2. Berk, M., Copolov, D. L., Dean, O., Lu, K., Jeavons, S., Schapkaitz, I., … & Bush, A. I. (2008). N-acetyl cysteine for depressive symptoms in bipolar disorder—a double-blind randomized placebo-controlled trial. Biological psychiatry, 64(6), 468-475.
  3. Berk, M., Dean, O. M., Cotton, S. M., Gama, C. S., Kapczinski, F., Fernandes, B., … & Allwang, C. (2012). Maintenance N-acetyl cysteine treatment for bipolar disorder: a double-blind randomized placebo controlled trial. BMC medicine, 10(1), 1.
  4. Magalhães, P. V., Dean, O. M., Bush, A. I., Copolov, D. L., Malhi, G. S., Kohlmann, K., … & Berk, M. (2011). N-acetylcysteine for major depressive episodes in bipolar disorder. Revista Brasileira de Psiquiatria, 33(4), 374-378.