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

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Synopsis

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

N-acetylcysteine (NAC) has received scientific attention as a potential adjunctive treatment for autism spectrum disorder (ASD), primarily due to its antioxidant properties and its role in modulating glutamatergic neurotransmission. Several small-scale randomized controlled trials (RCTs) have investigated NAC, particularly for addressing irritability and repetitive behaviors in children and adolescents with ASD. For example, a 2012 double-blind RCT by Hardan et al. found that NAC supplementation (up to 900 mg three times daily) over 12 weeks led to a significant reduction in irritability scores (measured by the Aberrant Behavior Checklist) compared to placebo. Other studies have reported modest improvements in irritability, aggression, and stereotypic behaviors, though results are mixed and not all studies have reached statistical significance.

The proposed mechanisms for NAC’s effects include reducing oxidative stress, replenishing glutathione (a key antioxidant in the brain), and modulating the glutamate system, which is sometimes dysregulated in ASD. However, the overall quality of evidence is limited by small sample sizes, short durations, and variability in outcome measures. Meta-analyses and systematic reviews generally conclude that while NAC shows promise, evidence is insufficient to recommend it as a standard treatment for core ASD symptoms. Larger, long-term trials are necessary to clarify its efficacy and safety profile.

In summary, there is some scientific evidence supporting NAC’s use as an adjunct for specific behavioral symptoms in autism, but the evidence base remains preliminary and does not support widespread clinical adoption at this time.

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