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

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Synopsis

Source of validity: Scientific
Rating (out of 5): 3

N-Acetyl Cysteine (NAC) has garnered scientific interest as an adjunctive treatment for schizophrenia. Several randomized controlled trials and meta-analyses have investigated its efficacy, particularly for negative symptoms and cognitive deficits, which are often poorly responsive to standard antipsychotic medications. NAC is a precursor to glutathione, a key antioxidant, and may help counteract the oxidative stress and glutamatergic dysfunction implicated in the pathophysiology of schizophrenia. Clinical studies suggest modest benefits: for example, a 2016 meta-analysis (Yolland et al., 2020, "Meta-analysis of N-acetylcysteine in schizophrenia") found that adjunctive NAC produced small-to-moderate improvements in negative symptoms, with less consistent effects on positive symptoms or cognition. The typical doses studied are 1,000–2,400 mg per day, added to existing antipsychotic regimens, with benefits often emerging after several months of treatment. Despite these findings, the overall quality of evidence is moderate, with some studies showing no significant benefit. Safety profiles are generally favorable. National and international psychiatric guidelines do not yet endorse NAC as standard treatment for schizophrenia, but research continues, and it may be considered in treatment-resistant cases or where negative symptoms predominate.

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