Cognitive effects of adjunctive N-acetyl cysteine in psychosis

Rapado-Castro, M., Dodd, S., Bush, A.I., Malhi, G.S., Skvarc, D.R., On, Z.X., Berk, M. and Dean, O.M. 2017, Cognitive effects of adjunctive N-acetyl cysteine in psychosis, Psychological medicine, vol. 47, no. 5, pp. 866-876, doi: 10.1017/S0033291716002932.

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Title Cognitive effects of adjunctive N-acetyl cysteine in psychosis
Author(s) Rapado-Castro, M.
Dodd, S.ORCID iD for Dodd, S.
Bush, A.I.
Malhi, G.S.
Skvarc, D.R.ORCID iD for Skvarc, D.R.
On, Z.X.
Berk, M.ORCID iD for Berk, M.
Dean, O.M.ORCID iD for Dean, O.M.
Journal name Psychological medicine
Volume number 47
Issue number 5
Start page 866
End page 876
Total pages 11
Publisher Cambridge University Press
Place of publication Cambridge, Eng.
Publication date 2017-04
ISSN 1469-8978
Keyword(s) N-acetyl cysteine
working memory
Summary BACKGROUND: Cognitive deficits are predictors of functional outcome in patients with psychosis. While conventional antipsychotics are relatively effective on positive symptoms, their impact on negative and cognitive symptoms is limited. Recent studies have established a link between oxidative stress and neurocognitive deficits in psychosis. N-acetylcysteine (NAC), a glutathione precursor with glutamatergic properties, has shown efficacy on negative symptoms and functioning in patients with schizophrenia and bipolar disorder, respectively. However, there are few evidence-based approaches for managing cognitive impairment in psychosis. The present study aims to examine the cognitive effects of adjunctive NAC treatment in a pooled subgroup of participants with psychosis who completed neuropsychological assessment in two trials of both schizophrenia and bipolar disorder.

METHOD: A sample of 58 participants were randomized in a double fashion to receive 2 g/day of NAC (n = 27) or placebo (n = 31) for 24 weeks. Attention, working memory and executive function domains were assessed. Differences between cognitive performance at baseline and end point were examined using Wilcoxon's test. The Mann-Whitney test was used to examine the differences between the NAC and placebo groups at the end point.

RESULTS: Participants treated with NAC had significantly higher working memory performance at week 24 compared with placebo (U = 98.5, p = 0.027).

CONCLUSIONS: NAC may have an impact on cognitive performance in psychosis, as a significant improvement in working memory was observed in the NAC-treated group compared with placebo; however, these preliminary data require replication. Glutamatergic compounds such as NAC may constitute a step towards the development of useful therapies for cognitive impairment in psychosis.
Language eng
DOI 10.1017/S0033291716002932
Field of Research 110319 Psychiatry (incl Psychotherapy)
1701 Psychology
1117 Public Health And Health Services
1109 Neurosciences
Socio Economic Objective 920410 Mental Health
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, Cambridge University Press
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Document type: Journal Article
Collections: Faculty of Health
School of Psychology
School of Medicine
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