N-Acetyl Cysteine Benefits those with Bipolar Disorder

by | Jan 6, 2016 | 2008, Antioxidants, Depression, NAC (N-Acetyl Cysteine)

Written by Greg Arnold, DC, CSCS. Those who took 2 grams of N-acetyl choline for 24 weeks had a significant 63.5% improvement in depression scores and a 54.6% improvement in bipolar depression scores compared to placebo.

Bipolar disorder, sometimes referred to as manic-depressive disorder, is characterized by dramatic shifts in mood, energy, and activity levels that affect a person’s ability to carry out everyday tasks and frequently require medication. Bipolar disorder affects 2.6% of U.S. adults, with 82.9% of those cases classified as “severe” (1).

Fortunately, alternative treatments are starting to become available for those with bipolar disorder, specifically an antioxidant called N-acetyl cysteine. A 2008 study (2) involved 68 subjects (30 men, 38 women) diagnosed with bipolar disorder in the maintenance phase. They were given either 2 grams (1 gram twice daily) of N-acetyl cysteine (34 subjects) or placebo (34 subjects) in addition to their medication regimen for 24 weeks. After this, there was a 4-week washout period and the subjects switched treatments. The 2-gram dose was used because it is the highest tolerable dose that produced benefits in published clinical trials for up to 1 year (3, 4, 5). It also showed benefits and an “excellent safety profile” in a phase 2 schizophrenia trial (6).

The biggest benefit seen with N-acetyl Cysteine supplementation was improvements in the Montgomery Asberg Depression Rating Scale and the Bipolar Depression Rating Scale (7). Specifically, N-acetyl Cysteine decreased Montgomery Asberg Depression Rating Scale scores by 60.3% (16.6 to 6.6) compared to a 6.8% increase in the placebo group (13.1 to 14.0, p = 0.02). For the Bipolar Depression Rating Scale, those in the N-Acetyl Cysteine group had a 57.1% decrease (15.6 to 6.7) in their scores, compared to a 2.5% decrease in the placebo group (12.3 to 12.0, p = 0.012). What’s more, these improvements were not seen after the 4-week washout.

For the researchers, “The benefits we observed indicate that disturbances in oxidative neurochemistry may play a role in bipolar disorder and that augmentation of glutathione using N-acetyl cysteine supplementation in the maintenance phase reduces depressive symptoms and improves functioning and quality of life over a 6-month period.”

Source: Berk, Michael, et al. “N-acetyl cysteine for depressive symptoms in bipolar disorder—a double-blind randomized placebo-controlled trial.” Biological psychiatry 64.6 (2008): 468-475.

© 2008 Society of Biological Psychiatry

Posted November 23, 2015.

Greg Arnold is a Chiropractic Physician practicing in Hauppauge, NY.  You can contact Dr. Arnold directly by emailing him at PitchingDoc@msn.com or visiting his web site at www.PitchingDoc.com.

References:

  1. “Bipolar Disorder Among Adults” posted on the National Institutes of Mental Health website
  2. Berk M. N-acetyl cysteine for depressive symptoms in bipolar disorder–a double-blind randomized placebo-controlled trial. Biol Psychiatry 2008 Sep 15; 64(6):468-75. doi: 10.1016/j.biopsych.2008.04.022. Epub 2008 Jun 5
  3. Van Schooten FJ, Besaratinia A, De Flora S, D’Agostini F, Izzotti A, Camoirano A, et al. Effects of oral administration of N-acetyl-L-cysteine: A multi-biomarker study in smokers. Cancer Epidemiol Biomarkers Prev 2002; 11:167–175
  4. Behr J, Degenkolb B, Krombach F, Vogelmeier C. Intracellular glutathione and bronchoalveolar cells in fibrosing alveolitis: Effects of N-acetylcysteine. Eur Respir J 2002; 19:906 –911
  5. Demedts M, Behr J, Buhl R, Costabel U, Dekhuijzen R, Jansen HM, et al. High-dose acetylcysteine in idiopathic pulmonary fibrosis. N Engl J Med 2005; 353:2229 –2242.
  6. Berk M, Copolov D, Dean O, Lu K, Jeavons S, Schapkaitz I, et al. N-acetyl cysteine as a glutathione precursor for schizophrenia: A double-blind, randomized, placebo-controlled trial [published online ahead of print April 22]. Biol Psychiatry 2008
  7. Berk M, Malhi GS, Cahill C, Carman AC, Hadzi-Pavlovic D, Hawkins MT, et al. (2007): The Bipolar Depression Rating Scale (BDRS): Its development, validation and utility. Bipolar Disord 9:571–579