Meta-analysis of randomised controlled trials with-acetylcysteine in the treatment of schizophrenia.
Aust N Z J Psychiatry. 2019 Dec 11:4867419893439. Epub 2019 Dec 11. PMID: 31826654
Caitlin Ob Yolland
OBJECTIVE: There is accumulating evidence that adjunctive treatment with-acetylcysteine may be effective for schizophrenia. This study aimed to conduct a comprehensive meta-analysis examining the efficacy of randomised control trials investigating-acetylcysteine as an adjunct treatment for schizophrenia and the first to investigate cognition as an outcome.
METHODS: We systematically reviewed Medline, EmCare, PsycINFO, Embase, CINAHL Complete, China Knowledge Resource Integrated Database and the Cochrane Clinical Trials online registry for randomised control trials of-acetylcysteine for schizophrenia. We undertook pairwise meta-analyses of-acetylcysteine vs placebo for psychosis symptoms and cognition.
RESULTS: Seven studies, including= 220 receiving-acetylcysteine and= 220 receiving placebo, met inclusion criteria for the pairwise meta-analyses. Positive and Negative Syndrome Scale negative and total scores were significantly improved in the-acetylcysteine group after 24 weeks of treatment. The cognitive domain of working memory improved with-acetylcysteine supplementation.
CONCLUSION: Evidence supports the notion that-acetylcysteine may be a useful adjunct to standard treatment for the improvement of schizophrenia symptoms, as well as the cognitive domain of working memory. Treatment effects were observed at the later time point (⩾24 weeks), suggesting that longer interventions are required for the success of-acetylcysteine treatment.