The safety and efficacy of N-acetylcysteine as an augmentation in the treatment of obsessive-compulsive disorder in adults: a systematic review and meta-analysis of randomized clinical trials.

Eghdami S, Eissazade N, Heidari Mokarar M, et al. (2024) Frontiers in psychiatry
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Title and abstract of The safety and efficacy of N-acetylcysteine as an augmentation in the treatment of obsessive-compulsive disorder in adults: a systematic review and meta-analysis of randomized clinical trials.

Key Takeaway

Meta-analysis of 6 RCTs found NAC augmentation with SSRIs may benefit patients with moderate to severe OCD, showing improved Y-BOCS scores at 5-8 weeks

Summary

This systematic review and meta-analysis investigated NAC as a glutamate-modulating augmentation agent for moderate to severe OCD. Six RCTs with 195 patients were included. NAC augmentation with SSRIs showed positive outcomes on total Y-BOCS scores when used for 5-8 weeks.

Methods

Systematic review and meta-analysis searching databases through December 2023. Included 6 RCTs with 195 patients with moderate to severe OCD. Assessed NAC as augmentation to SSRIs. Published in Frontiers in Psychiatry.

Key Results

NAC with SSRIs showed positive outcome for total Y-BOCS score at 5-8 weeks (p = 0.05). 40-60% of OCD patients don't adequately respond to SSRIs alone, supporting augmentation approaches. NAC was well-tolerated.

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Limitations

Small number of studies (6 RCTs) and participants (195). Borderline statistical significance (p = 0.05). Short treatment durations (5-8 weeks). All assessed NAC as SSRI augmentation only. Multi-center trials needed.

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Source

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DOI: 10.3389/fpsyt.2024.1421150