Evidence supporting the use of: N-Acetyl Cysteine
For the health condition: Autism

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Synopsis

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

N-Acetyl Cysteine (NAC) has been investigated as a potential adjunctive treatment for autism spectrum disorder (ASD), particularly for addressing irritability and certain behavioral symptoms. The scientific rationale is primarily based on NAC's antioxidant properties and its role in modulating glutamate, a neurotransmitter implicated in ASD pathophysiology. Several small randomized controlled trials (RCTs) and open-label studies have examined the effects of NAC in children and adolescents with ASD. The most cited trial (Hardan et al., 2012) found that NAC, when added to standard treatment, resulted in a modest but statistically significant reduction in irritability scores compared to placebo. Other studies have reported similar findings, though the effect sizes are generally small and some trials have failed to replicate benefits. Systematic reviews and meta-analyses (e.g., Zhou et al., 2021) conclude that while there is preliminary evidence of benefit for irritability and possibly repetitive behaviors, the overall quality of evidence is low, with limitations such as small sample sizes, short durations, and methodological variability.

As of 2024, NAC is not considered a standard or primary treatment for ASD, and its use remains off-label. Major guidelines do not recommend routine NAC supplementation for autism. In summary, there is some scientific interest and preliminary evidence but not enough high-quality data to broadly endorse NAC for ASD.

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