What Future Role Might N-Acetyl-Cysteine Have in the Treatment of Obsessive Compulsive and Grooming Disorders?: A Systematic Review

J Clin Psychopharmacol. 2016 Feb;36(1):57-62. doi: 10.1097/JCP.0000000000000431.

Smith L1, Tracy DK, Giaroli G.

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Abstract

Licensed pharmacological treatments for obsessive-compulsive disorders include selective serotonin reuptake inhibitors and tricyclic antidepressants. However, a large proportion of patients show minimal or no therapeutic response to these treatments. The glutamatergic system has been implicated in the etiology of obsessive-compulsive spectrum disorders, and it has been postulated that n-acetyl-cysteine (NAC) could have a therapeutic effect on these conditions through its actions on the glutamatergic system and the reduction of oxidative stress. A systematic review was conducted on the existing methodologically robust literature regarding the efficacy of NAC on obsessive-compulsive spectrum disorders in adults and children. Four randomized, double-blind placebo-controlled studies were identified, investigating the effects of NAC on obsessive-compulsive disorder, trichotillomania, and onychophagia. Results remain inconclusive, but NAC may still be useful as a treatment for obsessive-compulsive spectrum disorders on an individual level, particularly as the compound has a relatively benign side-effect profile. The dearth of methodologically robust work is clinically important: larger randomized controlled trials are required to inform of any meaningful clinical effectiveness, and to better determine which, if any, clinical populations might most benefit.
Comentarios:
El uso de fármaco con acetilcisteína provoca un alivio sintomático de las afecciones del tracto respiratorio en los que se produce una producción excesiva de moco. Suele administrarse mediante uso oral: Sobres, comprimidos efervescentes, jarabes, etc.o por vía parenteral: Intramuscular, intravenosa, etc. Existen fármacos que permiten adminsistrar la acetilcisteina de forma inhalatoria. Se comercializa bajo los nombres de Aflux®, Fluimucil®, Lisomucil®, Flumil®. También se usa en el tratamiento de la intoxicación por paracetamol1 y más recientemente como coadyuvante en el tratamiento de la fibrosis pulmonar.2 Tiene como complemento la acción funcional en el sistema excretor, corrigiendo intoxicaciones inducidas por medicamentos administrados en procedimientos intrahospitalarios (medios de contraste) utilizados en estudios contrastados para mejorar visibilidad de los órganos, y medio de diagnóstico muy utilizado debido a su eficacia.