[The double-blind randomized placebo-controlled trial of N-acetylcysteine use in schizophrenia: preliminary results].
Zh Nevrol Psikhiatr Im S S Korsakova. 2020 ;120(9):66-71. PMID: 33081449
A S Pyatoykina
BACKGROUND: Currently, oxidative stress as part of the pathogenesis of schizophrenia attracts much attention. In this regard, it becomes relevant to assess the level of redox imbalance in patients with schizophrenia, its impact on existing symptoms and the possibility of its treatment. The antioxidant N-acetylcysteine is one of the potential drugs that affects oxidative stress.
OBJECTIVE: To study the possibilities of the use of N-acetylcysteine in patients with schizophrenia.
MATERIAL AND METHODS: The study included 20 patients diagnosed with paranoid schizophrenia with the disease duration of less than 3 years, randomly assigned to the main group (taking N-acetylcysteine at a dose of 2000 mg per day for 60 days) and a comparison group (placebo) in a double-blinded manner. At the beginning and end of the study, cognitive functions were evaluated using the specialized instrument BACS, the severity of psychopathological symptoms was evaluated using PANSS, and blood was collected to determine the level of glutathione (GSH), which is a metabolite of N-acetylcysteine.
RESULTS: There was a significant decrease in positive PANSS score (=0.013), negative PANSS score (=0.002) and the general pathology PANSS score (=0.004) in the main group. Compared with the comparison group, the dynamics of the negative PANSS score (=0.005) and the general psychopathology PANSS score (=0.004) was significantly different. When assessing the dynamics of cognitive functions in the main group, a significant improvement in indicators was established in the task for a sequence of numbers that characterizes working memory (=0.037). The level of GSH significantly increased in the main group (=0.01), however, there were no statistically significant differences between groups at the final visit.
CONCLUSION: N-acetylcysteine has a positive effect on the negative, general psychopathology PANSS scores, some cognitive functions, in particular, working memory, that allows considering this drug as a promising method of augmentation of schizophrenia therapy and requires further attentive study.