Objective: Oxidative imbalance has emerged as a treatment target in bipolar disorder. As very limited data are available on the clinical use of antioxidants for mania, we report here results from a post hoc and exploratory subgroup analysis of a randomized, placebo-controlled trial of N-acetyl cysteine (NAC). Methods: This was a placebo-controlled, randomized, clinical trial assessing the effect of NAC over 24 weeks in mania or hypomania. Symptomatic and functional outcomes were collected over the study period. Results: Fifteen participants were available for this report; two participants in each group failed to complete all assessments. Within-group analyses pointed to an improvement in the NAC group on manic symptoms and worsening in the placebo group on depressive symptoms at endpoint. Conclusions: Although the sample size was small, these results indicated within-group efficacy for this glutathione precursor as compared to placebo. Future trials specifically designed to demonstrate the efficacy of NAC in mania are needed.
Da Silva Magalhaes, P. V. S., Dean, O., Bush, A. I., Copolov, D. L., Malhi, G. S., Kolhmann, K., Jeavons, S., Schapkaitz, I., Anderson-Hunt, M., & Berk, M. (2013). A preliminary investigation on the efficacy of N-acetyl cysteine for mania or hypomania. Australian & New Zealand Journal of Psychiatry, 47(6), 564 - 568. https://doi.org/10.1177/0004867413481631