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Article Publish Status: FREE
Abstract Title:

N-Acetylcysteine as a novel rapidly acting anti-suicidal agent: A pilot naturalistic study in the emergency setting.

Abstract Source:

PLoS One. 2022 ;17(1):e0263149. Epub 2022 Jan 28. PMID: 35089954

Abstract Author(s):

Davinder Hans, Anthony Rengel, Jaspreet Hans, Darryl Bassett, Sean Hood

Article Affiliation:

Davinder Hans

Abstract:

OBJECTIVE: N-acetylcysteine has a demonstrated role as an adjunctive therapy in psychotic and affective disorders as a treatment to reduce symptoms of Bipolar Affective Disorder, Major Depressive Disorder and Schizophrenia. However, its potential as a rapidly acting anti-suicidal agent has not yet been assessed. This naturalistic study evaluates its effect in thirty patients presenting following intentional medication overdose.

METHODS: Eighteen patients who ingested toxic doses of paracetamol received NAC whilst twelve other patients with other overdoses received standard supportive treatment in the emergency department setting. Symptoms were measured using the Montgomery-Asberg Depression Rating Scale and Clinical Global Impression scale at time of presentation, 24 hours, and seven days.

RESULTS: Baseline characteristics between groups were similar. Both groups showed a significant reduction in suicidality, as measured by the suicide item of the MADRS, over time (p<0.001). However, there was a greater reduction in suicidality in the 'NAC group' compared to the 'no-NAC group' one-week post presentation (p = 0.014). A greater proportion of the 'no-NAC group' still exhibited severe depressive symptoms (MADRS>32) compared to the 'NAC group' (p = 0.044).

CONCLUSION: This naturalistic study suggests NAC may have potential use as a rapidly acting treatment adjunct in major depressive disorder, warranting further investigation of its effects.

Study Type : Human Study

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Sayer Ji
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