Effects of N-acetylcysteine on substance use in bipolar disorder: A randomised placebo-controlled clinical trial

Michelle Bernardo, Seetal Dodd, Clarissa S. Gama, David L. Copolov, Olivia Dean, Kristy Kohlmann, Susan Jeavons, Ian Schapkaitz, Murray Anderson-Hunt, Ashley I. Bush, Michael Berk

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    Objective: To evaluate the effect of N-acetylcysteine (NAC) on substance use in a double-blind, placebo-controlled trial of NAC in bipolar disorder. It is hypothesised that NAC will be superior to placebo for reducing scores on the Clinical Global Impressions scale for Substance Use (CGI-SU). Methods: Participants were randomised to 6-months of treatment with 2 g/day NAC (n = 38) or placebo (n = 37). Substance use was assessed at baseline using the Habits instrument. Change in substance use was assessed at regular study visits using the CGI-SU. Results: Amongst the 75 participants 78.7% drank alcohol (any frequency), 45.3% smoked tobacco and 92% consumer caffeine. Other substances were used by fewer than six participants. Caffeine use was significantly lower for NAC-treated participants compared with placebo at week 2 of treatment but not at other study visits. Conclusion: NAC appeared to have little effect on substance use in this population. A larger study on a substance using population will be necessary to determine if NAC may be a useful treatment for substance use.

    Original languageEnglish
    Pages (from-to)239-245
    Number of pages7
    JournalActa Neuropsychiatrica
    Issue number5
    Publication statusPublished - 1 Jan 2009


    • Alcohol
    • Bipolar disorder
    • Caffeine
    • Clinical trial
    • N-acetyl cysteine
    • Smoking
    • Substance use

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