Journal
SCHIZOPHRENIA BULLETIN
Volume 48, Issue 6, Pages 1263-1272Publisher
OXFORD UNIV PRESS
DOI: 10.1093/schbul/sbac065
Keywords
mental illness; quality of life; cognition; depression; mental disorders; psychiatry; neuroscience
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Funding
- National Health and Medical Research Council [NHMRC GNT1098442]
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This study aimed to investigate the efficacy of adjunctive NAC in improving negative symptoms, cognition, and quality of life in treatment-resistant schizophrenia patients on clozapine treatment. The results showed that NAC did not significantly improve symptoms, cognition, or quality of life over a 1-year period compared to placebo, and there were no significant differences in reported side effects between the groups.
Background and Hypothesis Clozapine is the most effective antipsychotic for treatment-resistant schizophrenia, yet a significant proportion of individuals on clozapine continue to experience disabling symptoms, despite being treated with an adequate dose. There is a need for adjunct treatments to augment clozapine, notably for negative and cognitive symptoms. One such potential agent is the glutathione precursor N-acetylcysteine (NAC). Study Design A randomized double-blind, multi-center, placebo-controlled trial for clozapine patients with enduring psychotic symptoms (n = 84) was undertaken to investigate the efficacy of adjunctive NAC (2 g daily) for negative symptoms, cognition and quality of life (QoL). Efficacy was assessed at 8, 24, and 52 weeks. Study Results NAC did not significantly improve negative symptoms (P = .62), overall cognition (P = .71) or quality of life (Manchester quality of life: P = .11; Assessment of quality of life: P = .57) at any time point over a 1-year period of treatment. There were no differences in reported side effects between the groups (P = .26). Conclusions NAC did not significantly improve schizophrenia symptoms, cognition, or quality of life in treatment-resistant patients taking clozapine. This trial was registered with Australian and New Zealand Clinical Trials on the 30 May, 2016 (Registration Number: ACTRN12615001273572).
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