A randomized, double-blind, placebo-controlled trial of N-acetylcysteine as an adjuvant treatment for alcohol use disorder

Objective: We assessed the effect of N-acetylcysteine, as an adjuvant treatment, on treatment adherence (primary outcome) according to peripheral biomarkers and clinical improvement (secondary outcomes) in patients with alcohol use disorder. Methods: A 9-week randomized, double-blind, placebo-cont...

Full description

Saved in:
Bibliographic Details
Main Authors: Jaqueline B. Schuch, Fernanda Hansen, Thiago Hartmann, Daniela Benzano, Henrique M. Gomes, José Cláudio F. Moreira, Flavio Pechansky, Felix H.P. Kessler, Fabiana Galland, Daiane Silvello, Anne O. Sordi, Lisia von Diemen
Format: Article
Language:English
Published: Associação Brasileira de Psiquiatria (ABP) 2025-05-01
Series:Brazilian Journal of Psychiatry
Subjects:
Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-44462025000100212&lng=en&tlng=en
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Objective: We assessed the effect of N-acetylcysteine, as an adjuvant treatment, on treatment adherence (primary outcome) according to peripheral biomarkers and clinical improvement (secondary outcomes) in patients with alcohol use disorder. Methods: A 9-week randomized, double-blind, placebo-controlled clinical trial was conducted on 53 (n = 25 N-acetylcysteine, n = 28 placebo) inpatients with alcohol use disorder. Neuropeptide Y, oxidative stress and inflammatory biomarkers, and hepatic parameters were analyzed at 3 time points. Results: Seventeen (60.7%) patients in the placebo group and 16 (64%) patients in the N-acetylcysteine group completed the trial. Hepatic biomarker levels changed significantly over time (p < 0.001). Oxidized glutathione levels at admission were lower in the N-acetylcysteine group (ppairwise = 0.043). By the end of the study, both groups had similar oxidized glutathione levels (p = 0.868), and oxidized glutathione levels were lower in the placebo group. At the end of the intervention, superoxide dismutase activity had decreased and neuropeptide Y levels had increased in the N-acetylcysteine group. Both groups showed similar mean time to relapse, treatment adherence, and clinical improvement. Conclusions: Our findings reinforce the effects of alcohol on oxidative stress and neuropeptide Y parameters. However, our sample size may limit the generalizability of the results, especially for clinical outcomes. Future randomized clinical trials including patients with less severe alcohol use disorder and longer follow-up may be needed to determine whether N-acetylcysteine could help reduce the mental health burden of this disorder. Clinical Trial Registration: NCT03018236.
ISSN:1809-452X