Evidence supporting the use of: N-acetylcysteine
For the health condition: Anxiety Disorders

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Synopsis

Source of validity: Scientific
Rating (out of 5): 2

N-acetylcysteine (NAC) has been investigated as a potential adjunctive treatment for anxiety disorders, but the evidence remains preliminary and limited. NAC is a precursor to the antioxidant glutathione and is thought to influence glutamatergic and oxidative pathways, both of which have been implicated in the pathophysiology of anxiety disorders. Small randomized controlled trials (RCTs) and open-label studies have assessed NAC in populations with comorbid anxiety and other psychiatric conditions (such as obsessive-compulsive disorder, bipolar disorder, and substance use). Some studies report modest reductions in anxiety symptoms, but these effects are not consistent or robust across the literature. Systematic reviews and meta-analyses (e.g., Deepmala et al., 2015, and Minarini et al., 2017) note that while NAC appears safe and may have some beneficial effects on mood and anxiety-related symptoms, the evidence is insufficient to recommend its routine use for primary anxiety disorders. Most studies are small, have methodological limitations, and often include participants with multiple comorbidities, making it difficult to isolate effects on pure anxiety disorders. At present, NAC is not a first-line treatment for anxiety, but ongoing research may clarify its role as an adjunctive therapy in the future.

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