N-Acetylcysteine (NAC)

Presentation by Khadiga Fouad

Peer-reviewed by Emily Morgan & Shikha Jha

Introduction:

N-Acetylcysteine (NAC) is a precursor of cysteine, an amino acid. NAC is a known antioxidant and anti-inflammatory drug that is used to treat various diseases, such as acetaminophen toxicity, chronic bronchitis, asthma, Alzheimer’s, and Parkinson’s disease. (Mokhtari et al., 2016). Several studies have focused on NAC as a potential treatment for cocaine, heroin, nicotine, and alcohol use disorders. The studies have focused on understanding the neurological mechanism of NAC and its effects on reducing drug seeking behaviors, cravings, and withdrawal symptoms (Mcclure et al., 2014). NAC would be most beneficial “in preventing relapse after an individual has achieved abstinence” (Tomko et al., 2018).

Future Research

  • Studies need to be conducted in regard to pregnant women and NAC treatment

  • Further research must be done to determine the effectiveness of NAC in promoting abstinence, both as a stand-alone treatment and as part of an addiction treatment plan.

 

References

Acetylcysteine (acetylcysteine) dose, indications, adverse effects, interactions. from PDR.net. (n.d.). PDR.Net. https://www.pdr.net/drug-summary/Acetylcysteine-acetylcysteine-668

Back, S. E., McCauley, J. L., Korte, K. J., Gros, D. F., Leavitt, V., Gray, K. M., Hamner, M. B., DeSantis, S. M., Malcolm, R., Brady, K. T., & Kalivas, P. W. (2016). A double-blind, randomized, controlled pilot trial of N-acetylcysteine in veterans with posttraumatic stress disorder and substance use disorders. Journal of Clinical Psychiatry, 77(11), e1439–e1446. https://doi.org/10.4088/JCP.15m10239

Ershad, M., Naji, A., & Vearrier, D. (2020, June 28). N Acetylcysteine - StatPearls –NCBI bookshelf. National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/books/NBK537183/

Mcclure, E. A., Gipson, C. D., & Gray, K. M. (2014). Potential role of NAC in SUDs. CNS Drugs, 28(2), 95–106. https://doi.org/10.1007/s40263-014-0142-x.Potential

Mokhtari, V., Afsharian, P., Shahhoseini, M., Kalantar, S. M., & Moini, A. (2017). A Review on Various Uses of N-Acetyl Cysteine Citation: Mokhtari V, Afsharian P, Shahhoseini M, Kalantar SM, Moini A. A review on various uses of N-acetyl. CELL JOURNAL(Yakhteh) Cell Journal (Yakhteh) Cell J, 19(191), 11–17. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5241507/pdf/Cell-J-19-11.pdf

NAC drug interactions. Drugs.com. https://www.drugs.com/drug-interactions/acetylcysteine,nac.html

LaRowe, S. D., Mardikian, P., Malcolm, R., Myrick, H., Kalivas, P., McFarland, K., Saladin, M., McRae, A., & Brady, K. (2006). Safety and tolerability of N-acetylcysteine in cocaine-dependent individuals. American Journal on Addictions, 15(1), 105–110. https://doi.org/10.1080/10550490500419169

Tomko, R. L., Jones, J. L., Gilmore, A. K., Brady, K. T., Back, S. E., Gray, K. M., & Author, C. P. (2018). N-acetylcysteine: A potential treatment for substance use disorders HHS Public Access Author manuscript. Curr Psychiatr,17(6), 30–55. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5993450/pdf/nihms964189.pdf