N-acetylcysteine for therapy-resistant tobacco use disorder: a pilot study.

Abstract

INTRODUCTION:

N-Acetylcysteine (NAC) may have efficacy in treating tobacco use disorder (TUD) by reducing craving and smoking reward. This study examines whether treatment with NAC may have a clinical efficacy in the treatment of TUD.

METHODS:

A 12-week double blind randomized controlled trial was conducted to compare the clinical efficacy of NAC 3 g/day versus placebo. We recruited 34 outpatients with therapy resistant TUD concurrently treated with smoking-focused group behavioral therapy. Participants had assessments of daily cigarette use (primary outcome), exhaled carbon monoxide (CO(EXH)) (secondary outcome), and quit rates as defined by CO(EXH) < 6 ppm. Depression was measured with the Hamilton Depression Rating Scale (HDRS). Data were analyzed using conventional and modified intention-to-treat endpoint analyses.

RESULTS:

NAC treatment significantly reduced the daily number of cigarettes used (Δ mean ± SD = -10.9 ± 7.9 in the NAC-treated versus -3.2 ± 6.1 in the placebo group) and CO(EXH) (Δ mean ± SD = -10.4 ± 8.6 ppm in the NAC-treated versus -1.5 ± 4.5 ppm in the placebo group); 47.1% of those treated with NAC versus 21.4% of placebo-treated patients were able to quit smoking as defined by CO(EXH) < 6 ppm. NAC treatment significantly reduced the HDRS score in patients with tobacco use disorder.

CONCLUSIONS:

These data show that treatment with NAC may have a clinical efficacy in TUD. NAC combined with appropriate psychotherapy appears to be an efficient treatment option for TUD.

• Authors: Eduardo Prado, Michael Maes, Luiz Gustavo Piccoli, Marcela Baracat, Décio Sabattini Barbosa, Olavo Franco, Seetal Dodd, Michael Berk, Sandra Odebrecht Vargas Nunes
• Journal: Redox report : communications in free radical research (Redox Rep) Vol. 20 Issue 5 Pg. 215-22 (Sep 2015) ISSN: 1743-2928 [Electronic] England
• PMID: 25729878 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Glutathione
• Acetylcysteine

Topics

• Acetylcysteine (administration & dosage, therapeutic use)
• Adolescent
• Adult
• Aged
• Double-Blind Method
• Female
• Glutathione (metabolism)
• Humans
• Male
• Middle Aged
• Oxidative Stress (drug effects)
• Pilot Projects
• Tobacco Use Disorder (drug therapy, metabolism)
• Treatment Outcome
• Young Adult