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N-acetylcysteine versus placebo for treating nail biting, a double blind randomized placebo controlled clinical trial

journal contribution
posted on 2013-01-01, 00:00 authored by A Ghanizadeh, N Derakhshan, Michael BerkMichael Berk
Nail biting is a common behavioral problem. While there are established behavioral interventions for management, they are of modest efficacy, and there is minimal evidence for effective pharmacotherapy. This study investigated the role of N-acetylcysteine (NAC) a potent glutathione and glutamate modulator for the treatment of pathological nail biting in children and adolescents. This pilot randomized, double-blind, placebo-controlled clinical trial of NAC (800mg/day) or placebo enrolled 42 children and adolescents with chronic nail biting. Nail length was the objective outcome. Evaluations were carried out three times; before treatment, one month after enrollment in the study, and two months after enrollment. The duration (chronicity) of nail biting in the NAC and placebo groups was 3.63(2.45) and 5.09(3.74) years (P=0.14). The mean nail length gradually increased in both the NAC and placebo groups during this trial. There was a statistically significant difference between the two groups regarding increased nail length after the first month of trial [(5.21(5.75) and 1.18(3.02) millimeters], however no difference after two months was observed. Two patients in the NAC group discontinued medication due to adverse events. One patient experienced headache, agitation, and social withdrawal, and another patient expressed severe aggression after taking medication and was withdrawn from the study. This study supports the hypothesis that NAC decreases nail biting behavior in children and adolescents over the short term. NAC is relatively well tolerated and severe adverse effects are rare. However, there was a high rate of dropout. Further studies with longer durations that build on these preliminary data are recommended.

History

Journal

Anti-Inflammatory and Anti-Allergy Agents in Medicinal Chemistry

Volume

12

Issue

3

Pagination

1 - 6

Publisher

Bentham Science Publishers

Location

Bussum, Netherlands

ISSN

1871-5230

Language

eng

Publication classification

C1 Refereed article in a scholarly journal

Copyright notice

2013, Bentham Science Publishers

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