Effects of adjunctive N-acetylcysteine on depressive symptoms: Modulation by baseline high-sensitivity C-reactive protein

• Published in: Psychiatry research 2018-05, Vol.263, p.268-274
• Main Authors: Porcu, Mauro, Urbano, Mariana Ragassi, Verri, Waldiceu A., Barbosa, Decio Sabbatini, Baracat, Marcela, Vargas, Heber Odebrecht, Machado, Regina Célia Bueno Rezende, Pescim, Rodrigo Rossetto, Nunes, Sandra Odebrecht Vargas
• Format: Article
• Language: English
• Subjects: Acetylcysteine - administration & dosage; Adult; Biomarkers; Biomarkers - blood; Bipolar depression; C-reactive protein; C-Reactive Protein - metabolism; Clinical trial; Depression; Depression - blood; Depression - drug therapy; Depression - psychology; Double-Blind Method; Drug Therapy, Combination; Female; Humans; Inflammation; Male; Middle Aged; N-acetyl-cysteine; Quality of Life - psychology; Treatment Outcome
• ISSN: 0165-1781; 1872-7123
• DOI: 10.1016/j.psychres.2018.02.056

Outcomes in a RCTs of 12 weeks of theclinical efficacy of N-acetylcysteine (NAC) as an adjunctive treatment on depression and anxiety symptoms and its effects on high-sensitivity C-reactive protein (hs-CRP) levels. A wide array of measures were made. The 17-item version of the Hamilton Depression Rating Scale (HDRS17); the Hamilton Anxiety Rating Scale (HAM-A); Sheehan Disability Scale; Quality of Life; Clinical Global Impression (CGI); anthropometrics measures; and vital signs and biochemical laboratory. There were no significant differences among the groups regarding demographic, clinical features, use of medication, metabolic syndrome and comorbidities. From baseline to week 12, individuals receiving NAC, versus placebo, had a statistically significant reduction in depressive symptoms on HDRS17 (p  3 mg/L at baseline. Individuals receiving NAC with baseline levels of hs-CRP > 3 mg/L, had more significant reduction in uric acid levels compared to individuals with baseline levels of hs-CRP ≤ 3 mg/L on week 12. Participants receiving placebogained significantly more weight during the 12 weeks for baseline levels of hs-CRP ≤ 3 mg/L and hs-CRP > 3 mg/L, and individuals receiving NAC in both groups did not have significant weight change during the 12 weeks. No individuals were withdrawn from the study because of adverse event. NAC group exhibited significantly greater reduction on hs-CRP levels than placebo group from baseline to week 12. Trial registration: clinicaltrials.gov Identifier; NCT02252341 •Add-onNAC treatment contribute to reduce depressive and anxiety symptoms, when baseline hs-CRP> 3 mg/L.•Add-onNAC treatment contribute toimprove work impairment, when baseline hs-CRP > 3 mg/L.•Plasma levels of hs-CRP should be done before treatment in individuals with depressive symptoms.•Add–on NAC treatment contribute to reduce hs-CRP levels.