Evidence map›Paper›PMID 29462456›Full record

Trial reportSchizophrenia bulletin2018

N-acetylcysteine in a Double-Blind Randomized Placebo-Controlled Trial: Toward Biomarker-Guided Treatment in Early Psychosis.

Philippe Conus, Larry J Seidman, Margot Fournier, Lijing Xin, Martine Cleusix, Philipp S Baumann, Carina Ferrari, Ann Cousins, Luis Alameda, Mehdi Gholam-Rezaee and 10 more

Registry-linked trialOpen access · bronzeAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Schizophrenia bulletin, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05142735 (Effects of N-acetylcysteine on Psychosis-like Symptoms and a Neurophysiological Biomarker of the Clinical High Risk for Schizophrenia), which is not on this map. Cited by 92 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
92citing papers in PubMed, 4 pooled it
5.2field-weighted citation impact, top 4% 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.

NCT05142735 narecruitingnot on this mapstarted 2023, after this paper: background citation

Effects of N-acetylcysteine on Psychosis-like Symptoms and a Neurophysiological Biomarker of the Clinical High Risk for Schizophrenia

TypeinterventionalSponsorCentre for Addiction and Mental HealthRan2023 to 2026Enrolled90ConditionsProdromal SchizophreniaArmsN-Acetylcysteine, Placebo
3 · Its place in the literature

Who cites it

92 citing papers in PubMed, 4 syntheses or guidelines pooled it, 161 citations in OpenAlex.

  1. Pooled it
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  10. Schizophrenia: from mechanism to therapy.Science China. Life sciences · 2026
    Review
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  13. Novel drug treatments for schizophrenia.Nature reviews. Drug discovery · 2026
    Review
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32 more citing papers are in PubMed but not listed here.

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

20 authors at 6 institutions in 2 countries.

Philippe ConusTIPP (Treatment and Early Intervention in Psychosis Program), Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
Larry J SeidmanMassachusetts Mental Health Center, Public Psychiatry Division of the Beth Israel, Deaconess Medical Center, Harvard Medical School, Department of Psychiatry, Boston, MA.
Margot FournierCenter for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
Lijing XinAnimal Imaging and Technology Core (AIT), Center for Biomedical Imaging (CIBM), Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.
Martine CleusixCenter for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
Philipp S BaumannTIPP (Treatment and Early Intervention in Psychosis Program), Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
Carina FerrariCenter for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
Ann CousinsMassachusetts Mental Health Center, Public Psychiatry Division of the Beth Israel, Deaconess Medical Center, Harvard Medical School, Department of Psychiatry, Boston, MA.
Luis AlamedaTIPP (Treatment and Early Intervention in Psychosis Program), Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
Mehdi Gholam-RezaeeTIPP (Treatment and Early Intervention in Psychosis Program), Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
Philippe GolayTIPP (Treatment and Early Intervention in Psychosis Program), Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
Raoul JenniCenter for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
T-U Wilson WooMassachusetts Mental Health Center, Public Psychiatry Division of the Beth Israel, Deaconess Medical Center, Harvard Medical School, Department of Psychiatry, Boston, MA.
Matcheri S KeshavanMassachusetts Mental Health Center, Public Psychiatry Division of the Beth Israel, Deaconess Medical Center, Harvard Medical School, Department of Psychiatry, Boston, MA.
Chin B EapDepartment of Psychiatry, Unit of Pharmacogenetics and Clinical Psychopharmacology, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
Joanne WojcikMassachusetts Mental Health Center, Public Psychiatry Division of the Beth Israel, Deaconess Medical Center, Harvard Medical School, Department of Psychiatry, Boston, MA.
Michel CuenodCenter for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
Thierry BuclinDivision of Clinical Pharmacology, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
Rolf GruetterLaboratory of Functional and Metabolic Imaging, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.
Kim Q DoCenter for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
University of Lausanne · CHBeth Israel Deaconess Medical Center · USHarvard University · USCentre d'Imagerie BioMedicale · CHÉcole Polytechnique Fédérale de Lausanne · CHMcLean Hospital · US

Funding

Harvard Clinical and Translational Science Center (UL1)UL1TR000170 · NCATS · HARVARD MEDICAL SCHOOL · PI NADLER, LEE MARSHALL · 2012 to 2013
$31.4M
NCATS NIH HHS UL1 TR000170
6 · The paper itself

Abstract

Biomarker-guided treatments are needed in psychiatry, and previous data suggest oxidative stress may be a target in schizophrenia. A previous add-on trial with the antioxidant N-acetylcysteine (NAC) led to negative symptom reductions in chronic patients. We aim to study NAC's impact on symptoms and neurocognition in early psychosis (EP) and to explore whether glutathione (GSH)/redox markers could represent valid biomarkers to guide treatment. In a double-blind, randomized, placebo-controlled trial in 63 EP patients, we assessed the effect of NAC supplementation (2700 mg/day, 6 months) on PANSS, neurocognition, and redox markers (brain GSH [GSHmPFC], blood cells GSH levels [GSHBC], GSH peroxidase activity [GPxBC]). No changes in negative or positive symptoms or functional outcome were observed with NAC, but significant improvements were found in favor of NAC on neurocognition (processing speed). NAC also led to increases of GSHmPFC by 23% (P = .005) and GSHBC by 19% (P = .05). In patients with high-baseline GPxBC compared to low-baseline GPxBC, subgroup explorations revealed a link between changes of positive symptoms and changes of redox status with NAC. In conclusion, NAC supplementation in a limited sample of EP patients did not improve negative symptoms, which were at modest baseline levels. However, NAC led to some neurocognitive improvements and an increase in brain GSH levels, indicating good target engagement. Blood GPx activity, a redox peripheral index associated with brain GSH levels, could help identify a subgroup of patients who improve their positive symptoms with NAC. Thus, future trials with antioxidants in EP should consider biomarker-guided treatment.

Indexed as

BiomarkersOutcome Assessment, Health CareAcetylcysteineAdolescentAdultAntioxidantsCognitive DysfunctionDouble-Blind MethodFemaleGlutathioneGlutathione PeroxidaseHumansMagnetic Resonance SpectroscopyMaleOxidation-ReductionPrefrontal CortexAcetylcysteineAntioxidantsBiomarkersGlutathioneGlutathione Peroxidase

Identifiers

PMID29462456
PMCPMC5815074
OpenAlexW2602914130

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

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.