Meta-analysis of randomised controlled trials with N-acetylcysteine in the treatment of schizophrenia. (May 2020)

• Record Type: Journal Article
• Authors: Yolland, Caitlin OB; Hanratty, Donal; Neill, Erica; Rossell, Susan L; Berk, Michael; Dean, Olivia M; Castle, David J; Tan, Eric J; Phillipou, Andrea; Harris, Anthony WF; Barreiros, Ana Rita; Hansen, Abigail; Siskind, Dan
• Is Part Of: Australian and New Zealand journal of psychiatry. Volume 54:Number 5(2020)
• Page Start: 453
• Page End: 466
• Publication Date: 2020-05
• Subjects: N-acetylcysteine -- antioxidant -- glutathione -- schizophrenia -- psychosis; Psychiatry -- Periodicals; Psychiatry -- Australia -- Periodicals; Psychiatry -- New Zealand -- Periodicals; 616.89005
• DOI: 10.1177/0004867419893439
• Languages: English
• ISSNs: 0004-8674

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.