Evidence map›Paper›PMID 26374743›Full record

Trial reportCNS drugs2015

N-Acetyl Cysteine (NAC) in the Treatment of Obsessive-Compulsive Disorder: A 16-Week, Double-Blind, Randomised, Placebo-Controlled Study.

Jerome Sarris, Georgina Oliver, David A Camfield, Olivia M Dean, Nathan Dowling, Deidre J Smith, Jenifer Murphy, Ranjit Menon, Michael Berk, Scott Blair-West and 1 more

Open access · greenAbstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in CNS drugs, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed, 4 pooled it
10.6field-weighted citation impact, top 2% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

31 citing papers in PubMed, 4 syntheses or guidelines pooled it, 79 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Trial
  6. Trial
  7. Article
  8. Review
  9. Review
  10. The Potential ofInternational journal of environmental research and public health · 2022
    Review
  11. Review
  12. Review
  13. Article
  14. Inflammation, Obsessive-Compulsive Disorder, and Related Disorders.Current topics in behavioral neurosciences · 2021
    Article
  15. Review
  16. N-Acetylcysteine for Pediatric Obsessive-Compulsive Disorder: A Small Pilot Study.Journal of child and adolescent psychopharmacology · 2020
    Article
  17. Review
  18. Review
  19. Review
  20. Obsessive-compulsive disorder.Nature reviews. Disease primers · 2019
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 5 institutions in 1 country.

Jerome SarrisDepartment of Psychiatry, The Melbourne Clinic, The University of Melbourne, 2 Salisbury St, Richmond, Melbourne, VIC, 3121, Australia. jsarris@unimelb.edu.au.
Georgina OliverDepartment of Psychiatry, The Melbourne Clinic, The University of Melbourne, 2 Salisbury St, Richmond, Melbourne, VIC, 3121, Australia.
David A CamfieldCentre for Human Psychopharmacology, Swinburne University, Melbourne, VIC, Australia.
Olivia M DeanIMPACT Strategic Research Centre, School of Medicine, Deakin University, Barwon Health, Geelong, VIC, Australia.
Nathan DowlingDepartment of Psychiatry, The Melbourne Clinic, The University of Melbourne, 2 Salisbury St, Richmond, Melbourne, VIC, 3121, Australia.
Deidre J SmithDepartment of Psychiatry, The Melbourne Clinic, The University of Melbourne, 2 Salisbury St, Richmond, Melbourne, VIC, 3121, Australia.
Jenifer MurphyDepartment of Psychiatry, The Melbourne Clinic, The University of Melbourne, 2 Salisbury St, Richmond, Melbourne, VIC, 3121, Australia.
Ranjit MenonDepartment of Psychiatry, The Melbourne Clinic, The University of Melbourne, 2 Salisbury St, Richmond, Melbourne, VIC, 3121, Australia.
Michael BerkIMPACT Strategic Research Centre, School of Medicine, Deakin University, Barwon Health, Geelong, VIC, Australia.
Scott Blair-WestDepartment of Psychiatry, The Melbourne Clinic, The University of Melbourne, 2 Salisbury St, Richmond, Melbourne, VIC, 3121, Australia.
Chee H NgDepartment of Psychiatry, The Melbourne Clinic, The University of Melbourne, 2 Salisbury St, Richmond, Melbourne, VIC, 3121, Australia.
University of Melbourne · AUMelbourne Clinic · AUBarwon Health · AUOrygen Youth Health · AUUniversity of Wollongong · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundObsessive-compulsive disorder (OCD) is a disabling mental illness for which pharmacological and psychosocial interventions are all too often inadequate. Recent preclinical and clinical studies have implicated dysfunction of glutamatergic neurotransmission in the pathophysiology of OCD. The amino acid-based nutraceutical N-acetyl cysteine (NAC) is a safe and readily available agent that has been found to modify the synaptic release of glutamate in subcortical brain regions via modulation of the cysteine-glutamate antiporter.

objectiveThe aim of this study was to assess the efficacy and safety of NAC in treating OCD.

methodsA 16-week, double-blind, placebo-controlled, randomised trial using 3 g/day of NAC (1.5 g twice daily) in 44 participants (aged 18-70 years) with Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5)-diagnosed OCD, during 2013-2015. The primary outcome measure was the Yale-Brown Obsessive Compulsive Scale (YBOCS), conducted every 4 weeks.

resultsAnalysis of the full sample (intention-to-treat) with repeated measures mixed linear modelling revealed a nonsignificant time × treatment interaction for the YBOCS scale total score (p = 0.39). A per-protocol analysis removing protocol violators also failed to show a significant time × treatment interaction for YBOCS total score (p = 0.15). However, a significant time × treatment interaction was observed for the YBOCS 'Compulsions' subscale in favour of NAC (p = 0.013), with a significant reduction observed at week 12 (dissipating at week 16). At 16 weeks, only four (20%) participants were considered 'responders' (YBOCS ≥35% reduction at endpoint) versus four (27%) in the placebo group. The NAC was well-tolerated, aside from more cases of heartburn occurring compared with placebo (p = 0.045).

conclusionFurther research involving NAC for OCD may require larger samples to detect moderate or small effect sizes, involve dosage or formulation differences, use in concert with exposure therapy, or an additional post-study observational period to mitigate study withdrawal.

trial registrationACTRN12613000310763.

Indexed as

AcetylcysteineAdolescentAdultAgedAnalysis of VarianceDouble-Blind MethodFemaleFollow-Up StudiesFree Radical ScavengersHumansMaleMiddle AgedObsessive-Compulsive DisorderPsychiatric Status Rating ScalesRetrospective StudiesTime FactorsAcetylcysteineFree Radical Scavengers

Identifiers

PMID26374743
OpenAlexW1672973614

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.