PMID- 36384314
OWN - NLM
STAT- MEDLINE
DCOM- 20230626
LR  - 20230626
IS  - 1542-6270 (Electronic)
IS  - 1060-0280 (Linking)
VI  - 57
IP  - 7
DP  - 2023 Jul
TI  - "N-Acetylcysteine for Obsessive-Compulsive and Related Disorders in Children and 
      Adolescents: A Review".
PG  - 847-854
LID - 10.1177/10600280221138092 [doi]
AB  - OBJECTIVE: To evaluate clinical data using oral n-acetylcysteine (NAC) in 
      obsessive-compulsive and related disorders (OCDRD) treatment. DATA SOURCES: 
      PubMed, Ovid MEDLINE (1946-July 2022), and the Cochrane Library database were 
      searched using the terms NAC, children, adolescent, obsessive-compulsive disorder 
      (OCD), trichotillomania (TTM), excoriation, hoarding disorder, and body 
      dysmorphic disorder. Bibliographies were reviewed for relevant trials and case 
      studies. STUDY SELECTION AND DATA EXTRACTION: English language, clinical trials, 
      or case studies analyzing NAC use in patients aged 3 to 21 years old with OCDRD 
      as determined by the Diagnostic and Statistical Manual of Mental Disorders, 5th 
      Edition. DATA SYNTHESIS: Three randomized double-blind placebo-controlled trials 
      of NAC in children and adolescents studied 121 patients with OCDRD. Trials 
      assessed symptom severity from baseline to 10 to 12 weeks of NAC therapy. Two OCD 
      trials identified statistically significant improvements, with only 1 trial 
      demonstrating a clear clinically relevant difference from placebo. One trial in 
      TTM found no difference between the NAC and placebo. Adverse effects were mild 
      and included nausea, blurred vision, fatigue, tremor, and sweats. 
      N-acetylcysteine titrated to 2400 or 2700 mg/day in divided doses was the most 
      studied regimen. RELEVANCE TO PATIENT CARE AND CLINICAL PRACTICE: Many OCDRD 
      patients fail to completely respond to first-line treatment with cognitive 
      behavioral therapy (CBT) and/or selective serotonin reuptake inhibitors (SSRIs) 
      leaving practitioners with few additional treatment options. Preliminary efficacy 
      and safety data are presented in this review. CONCLUSIONS: Limited evidence 
      suggests children and adolescents with OCD refractory to SSRIs or CBT may benefit 
      from NAC augmentation.
FAU - Parli, Gabrielle M
AU  - Parli GM
AD  - College of Pharmacy, Southwestern Oklahoma State University, Weatherford, OK, 
      USA.
FAU - Gales, Mark A
AU  - Gales MA
AD  - College of Pharmacy, Southwestern Oklahoma State University, Weatherford, OK, 
      USA.
AD  - Department of Pharmacy Practice, College of Pharmacy, Southwestern Oklahoma State 
      University, Weatherford, OK, USA.
AD  - Department of Pharmacy, INTEGRIS Baptist Medical Center, Oklahoma City, OK, USA.
FAU - Gales, Barry J
AU  - Gales BJ
AD  - College of Pharmacy, Southwestern Oklahoma State University, Weatherford, OK, 
      USA.
AD  - Department of Pharmacy Practice, College of Pharmacy, Southwestern Oklahoma State 
      University, Weatherford, OK, USA.
AD  - Department of Pharmacy, INTEGRIS Baptist Medical Center, Oklahoma City, OK, USA.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20221116
PL  - United States
TA  - Ann Pharmacother
JT  - The Annals of pharmacotherapy
JID - 9203131
RN  - WYQ7N0BPYC (Acetylcysteine)
RN  - 0 (Selective Serotonin Reuptake Inhibitors)
SB  - IM
MH  - Humans
MH  - Adolescent
MH  - Child
MH  - Child, Preschool
MH  - Young Adult
MH  - Adult
MH  - Acetylcysteine/therapeutic use
MH  - Selective Serotonin Reuptake Inhibitors/therapeutic use
MH  - *Obsessive-Compulsive Disorder/drug therapy/diagnosis/psychology
MH  - *Cognitive Behavioral Therapy
MH  - *Drug-Related Side Effects and Adverse Reactions
MH  - Treatment Outcome
MH  - Randomized Controlled Trials as Topic
OTO - NOTNLM
OT  - dietary supplements
OT  - glutamate
OT  - neuropharmacology
OT  - obsessive/compulsive disorder
OT  - pediatrics
OT  - psychiatry
EDAT- 2022/11/18 06:00
MHDA- 2023/06/26 06:41
CRDT- 2022/11/17 09:35
PHST- 2023/06/26 06:41 [medline]
PHST- 2022/11/18 06:00 [pubmed]
PHST- 2022/11/17 09:35 [entrez]
AID - 10.1177/10600280221138092 [doi]
PST - ppublish
SO  - Ann Pharmacother. 2023 Jul;57(7):847-854. doi: 10.1177/10600280221138092. Epub 
      2022 Nov 16.