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

Center of Approach and Treatment for Smokers, University Hospital, Londrina State University, University Campus, Brazil; Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Brazil. Electronic address: mporcu@uol.com.br. Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Brazil; Department of Statistics, Exact Sciences Center, State University of Londrina, Brazil. Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Brazil; Department of Pathology, Biological Sciences Center, State University of Londrina, Brazil. Center of Approach and Treatment for Smokers, University Hospital, Londrina State University, University Campus, Brazil; Department of Clinical Analysis and Toxicological, State University of Londrina, Paraná, Brazil; Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Brazil. Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Brazil. Department of Clinical Medicine, Psychiatry Unit, Health Sciences Center, Londrina State University, University Hospital, Brazil; Center of Approach and Treatment for Smokers, University Hospital, Londrina State University, University Campus, Brazil; Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Brazil. Center of Approach and Treatment for Smokers, University Hospital, Londrina State University, University Campus, Brazil; Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Brazil. Department of Statistics, Exact Sciences Center, State University of Londrina, Brazil.

Psychiatry research. 2018;:268-274
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Abstract

UNLABELLED 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 < 0.01) and anxiety symptoms on HAM-A (p = 0.04), but only for individuals with levels of hs-CRP > 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.

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Publication Type : Randomized Controlled Trial

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