Cocaine dependence |
Mardikian11. Mathers CD, Lopez AD, Murray CJL. The burden of disease and
mortality by condition: data, methods, and results for 2001. New York: Oxford
University Press; 2006.
|
4-week open-label trial |
23 |
NAC 1.2 g (n=8); 2.4 g (n=9); 3.6 g (n=6) |
Reduction in self-reported cocaine use |
LaRowe22. Kalivas PW, Volkow ND. The neural basis of addiction: a pathology
of motivation and choice. Am J Psychiatry. 2005;162:1403-13.
|
Double-blind randomized crossover trial |
15 |
NAC 1.2 g or placebo for 3 days, followed by a 3-day crossover
phase after 4 days |
Less self-reported desire to use and less response to cocaine
cues during the NAC phase |
Schmaal33. Somaini L, Donnini C, Raggi MA, Amore M, Ciccocioppo R, Saracino
MA, et al. Promising medications for cocaine dependence treatment. Recent Pat
CNS Drug Discov. 2011;6:146-60.
|
Open-label randomized crossover trial |
22 |
Single 2.4 g NAC dose phase and a placebo phase in patients
(n=8) and controls (n=14) |
Reduction in glutamate levels in the dACC of cocaine-dependent
subjects after NAC |
Cannabis dependence |
Gray44. Olive MF, Cleva RM, Kalivas PW, Malcolm RJ. Glutamatergic
medications for the treatment of drug and behavioral addictions. Pharmacol
Biochem Behav. 2012;100:801-10.
|
4-week open-label trial |
24 |
NAC 1.2 g |
Reduction in self-reported craving |
Gray55. Baker DA, McFarland K, Lake RW, Shen H, Tang XC, Toda S, et al.
Neuroadaptations in cystine-glutamate exchange underlie cocaine relapse. Nat
Neurosci. 2003;6:743-9.
|
8-week double-blind randomized trial |
116 |
NAC 2.4 g (n=58) or placebo (n=58) |
More negative urine tests in the NAC group (odds ratio 2.4,
95%CI 1.1-5.2) |
Nicotine dependence |
Knackstedt66. Kalivas PW, Volkow N, Seamans J. Unmanageable motivation in
addiction: a pathology in prefrontal-accumbens glutamate transmission. Neuron.
2005;45:647-50.
|
4-week double-blind randomized trial |
29 |
NAC 2.4 g (n=14) or placebo (n=15) |
NAC group reported a non-significant reduction in the number of
cigarettes smoked |
Schmaal77. McFarland K, Lapish CC, Kalivas PW. Prefrontal glutamate release
into the core of the nucleus accumbens mediates cocaine-induced reinstatement of
drug-seeking behavior. J Neurosci. 2003;23:3531-7.
|
3.5-day double-blind randomized trial |
22 |
NAC 3.6 g (n=10) or placebo (n=12) |
No significant effect of NAC on craving and withdrawal
symptoms |
Methamphetamine dependence |
Grant88. Pierce RC, Bell K, Duffy P, Kalivas PW. Repeated cocaine augments
excitatory amino acid transmission in the nucleus accumbens only in rats having
developed behavioral sensitization. J Neurosci.
1996;16:1550-60.
|
8-week double-blind randomized trial |
31 |
NAC 0.6-2.4 g + naltrexone 50-200 mg (n=14) or placebo
(n=17) |
No differences in primary and secondary outcomes |
Pathological gambling |
Grant99. Baker DA, McFarland K, Lake RW, Shen H, Toda S, Kalivas PW.
N-acetyl cysteine-induced blockade of cocaine-induced reinstatement. Ann N Y
Acad Sci. 2003;1003:349-51.
|
I) 8-week open-label andII) 6-week double-blind trial in
responders |
13 |
NAC 1.8 g (n=6) placebo (n=7) |
I) Reduction in baseline symptoms (20.3 vs. 11.8, p <
0.001); II) More responders in NAC group (83.3 vs. 28.6) |