Trial reportBMC medicine2012
Maintenance N-acetyl cysteine treatment for bipolar disorder: a double-blind randomized placebo controlled trial.
Trial report in BMC medicine, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
29 citing papers in PubMed, 3 syntheses or guidelines pooled it, 91 citations in OpenAlex.
- The effect of N-acetylcysteine on bipolar depression: a systematic review and meta-analysis of randomized controlled trials.Psychopharmacology · 2021Pooled it
- N-acetylcysteine as an adjunctive treatment for bipolar depression and major depressive disorder: a systematic review and meta-analysis of double-blind, randomized placebo-controlled trials.Psychopharmacology · 2020Pooled it
- N-Acetylcysteine for the Treatment of Psychiatric Disorders: A Review of Current Evidence.BioMed research international · 2018Pooled it
- Trial
- The Glutamate-Glutathione axis in neuropsychiatric disorders and cancer: From shared mechanisms to non-invasive biomarkers.Redox biology · 2026Review
- Metabolic regulation to treat bipolar depression: mechanisms and targeting by trimetazidine.Molecular psychiatry · 2023Review
- Therapeutic Interventions to Mitigate Mitochondrial Dysfunction and Oxidative Stress-Induced Damage in Patients with Bipolar Disorder.International journal of molecular sciences · 2022Review
- Comparative efficacy of mitochondrial agents for bipolar disorder during depressive episodes: a network meta-analysis using frequentist and Bayesian approaches.Psychopharmacology · 2021Review
- Increasing Nrf2 Activity as a Treatment Approach in Neuropsychiatry.Molecular neurobiology · 2021Review
- Mitochondrial dysfunction as a critical event in the pathophysiology of bipolar disorder.Mitochondrion · 2021Review
- Intracellular Signaling Cascades in Bipolar Disorder.Current topics in behavioral neurosciences · 2021Review
- The Role of Mitochondria in Mood Disorders: From Physiology to Pathophysiology and to Treatment.Frontiers in psychiatry · 2021Review
- Fetal Neuroprotective Strategies: Therapeutic Agents and Their Underlying Synaptic Pathways.Frontiers in synaptic neuroscience · 2021Review
- The Multifaceted Therapeutic Role of N-Acetylcysteine (NAC) in Disorders Characterized by Oxidative Stress.Current neuropharmacology · 2021Review
- Disturbance of Oxidative Stress Parameters in Treatment-Resistant Bipolar Disorder and Their Association With Electroconvulsive Therapy Response.The international journal of neuropsychopharmacology · 2020Article
- Pharmacological Treatment of Bipolar Depression: What are the Current and Emerging Options?Neuropsychiatric disease and treatment · 2020Article
- Targeting the immune system in the treatment of bipolar disorder.Psychopharmacology · 2019Review
- The Staging of Major Mood Disorders: Clinical and Neurobiological Correlates.Psychiatry investigation · 2018Article
- Mitochondrial Agents for Bipolar Disorder.The international journal of neuropsychopharmacology · 2018Review
- Add-on treatment with N-acetylcysteine for bipolar depression: a 24-week randomized double-blind parallel group placebo-controlled multicentre trial (NACOS-study protocol).International journal of bipolar disorders · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors at 8 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundN-acetyl cysteine (NAC) is a glutathione precursor that has been shown to have antidepressant efficacy in a placebo-controlled trial. The current study aimed to investigate the maintenance effects of NAC following eight weeks of open-label treatment for bipolar disorder.
methodThe efficacy of a double blind randomized placebo controlled trial of 2 g/day NAC as adjunct maintenance treatment for bipolar disorder was examined. Participants (n = 149) had a Montgomery Asberg Depression Rating Score of ≥12 at trial entry and, after eight weeks of open-label NAC treatment, were randomized to adjunctive NAC or placebo, in addition to treatment as usual. Participants (primarily outpatients) were recruited through public and private services and through newspaper advertisements. Time to intervention for a mood episode was the primary endpoint of the study, and changes in mood symptoms, functionality and quality of life measures were secondary outcomes.
resultsThere was a substantial decrease in symptoms during the eight-week open-label NAC treatment phase. During the subsequent double-blind phase, there was minimal further change in outcome measures with scores remaining low. Consequently, from this low plateau, between-group differences did not emerge on recurrence, clinical functioning or quality of life measures.
conclusionsThere were no significant between-group differences in recurrence or symptomatic outcomes during the maintenance phase of the trial; however, these findings may be confounded by limitations.
trial registrationThe trial was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12607000074493).
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.