Research

NAC (N-Acetyl Cysteine)

168 peer-reviewed studies curated from PubMed and Semantic Scholar.

28
Meta-analyses
13
Systematic reviews
101
RCTs
26
Other studies
Meta-analyses (17%)
Systematic reviews (8%)
RCTs (60%)
Observational (2%)

Studies

Sorted by quality and recency

2026·Environmental toxicology and pharmacology·Mohamed Abdeltawab, Abdel-Hameed Ebid, Osama Ahmed, et al

N-acetylcysteine reduces incidence and duration of linezolid-associated thrombocytopenia in critically ill patients: A randomized controlled trial.

RCTn = 250

This double-blind, randomized, placebo-controlled trial evaluated intravenous N-acetylcysteine (IV NAC) for prevention of linezolid-associated thrombocytopenia (LAT) in 250 critically ill adults. NAC significantly reduced LAT incidence, platelet transfusions, and linezolid discontinuations, and delayed LAT onset while accelerating platelet recovery.

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2026·Amino acids·Imran Mohammed, Yasimin Nankya, U Teng Hong, et al

The role of N-acetylcysteine and glutathione in the management of Parkinson's disease: a systematic review of oxidative biomarkers and clinical outcomes.

Systematic reviewn = 196Brain Health

Systematic review of nine studies involving 196 participants evaluating the effects of N-acetylcysteine (NAC) and glutathione (GSH) on oxidative stress and Parkinson's Disease symptoms. NAC improved motor and non-motor symptoms and increased GSH/GSSG ratios and DAT binding, while GSH showed modest increases in brain levels without significant symptom improvement. Evidence remains preliminary due to small sample sizes and short intervention durations.

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2026·International journal of molecular sciences·Robert Mîndreanu, Irina Camelia Chiș, Alexandra Sevastre-Berghian, et al

N-Acetylcysteine in Neurological Disorders: A Systematic Review of Clinical and Translational Evidence Across Seven Disorders.

Systematic reviewBrain Health Inflammation

Systematic review of 23 studies on N-acetylcysteine (NAC) as a neuroprotective agent across seven neurological disorders. Strongest evidence for NAC was found in acute mild TBI and Parkinson's disease, with trends toward cognitive stabilization in Alzheimer's disease. NAC showed a favorable safety profile, but evidence was fragmented and heterogeneous.

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2026·Journal of the College of Physicians and Surgeons--Pakistan : JCPSP·Babar Rafique, Abdul Rehman Arshad, Sohail Sabir, et al

N-acetylcysteine as Prophylaxis Against Contrast-Induced Nephropathy: A Meta-Analysis.

Meta-analysis

Meta-analysis of 49 studies assessing the effect of N-acetylcysteine (NAC) in preventing contrast-induced nephropathy. Neither oral nor intravenous NAC decreased the risk of acute kidney injury, the need for haemodialysis, or mortality.

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2025·Progress in neuro-psychopharmacology & biological psychiatry·Chun-Wei Liang, Hsiao-Yi Cheng, Mei-Chih Meg Tseng

Augmentation with glutamatergic modulators for schizophrenia: A network meta-analysis.

Meta-analysisn = 12,339Brain Health

Network meta-analysis of 148 RCTs with 12,339 patients evaluating glutamatergic modulators as augmentation treatments for schizophrenia. N-acetylcysteine, sarcosine, and memantine showed efficacy across multiple outcome domains, with specific agents like piracetam and benzoate improving psychopathology and positive symptoms, respectively.

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2025·Inflammopharmacology·Chia Siang Kow, Dinesh Sangarran Ramachandram, Syed Shahzad Hasan, et al

Effect of N-Acetylcysteine on mortality in COVID-19 patients: A systematic review and meta-analysis of randomized controlled trials.

Meta-analysisn = 1,424Longevity

Systematic review and meta-analysis of 10 RCTs with 1,424 COVID-19 patients evaluating N-acetylcysteine (NAC) on mortality. The pooled odds ratio indicated a 51% reduction in the odds of death among patients receiving NAC. NAC may reduce mortality, especially at higher doses or non-oral routes.

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2025·BMC gastroenterology·Ahmad Hormati, Asma Mousavi, Shayan Shojaei, et al

Efficacy of N-Acetylcysteine in preventing post-endoscopic retrograde cholangiopancreatography pancreatitis: a systematic review and meta-analysis.

Meta-analysisn = 773

Systematic review and meta-analysis of four RCTs involving 773 patients to evaluate the effectiveness of N-Acetylcysteine (NAC) in preventing post-ERCP pancreatitis. The meta-analysis showed a non-significant lower incidence of pancreatitis in the NAC group compared to controls, with moderate heterogeneity among studies. Further research is needed to clarify NAC's role as a prophylactic agent.

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2025·Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica·Syarif Syarif, Moh Anfasa Giffari Makkaraka, Ahmad Taufik Fadillah Zainal, et al

Unlocking the potential of antioxidant supplementation with n-acetylcysteine to improve seminal parameters and analysis of its safety: a systematic review and meta-analysis of randomized controlled trials.

Meta-analysisSexual Health

This systematic review and meta-analysis evaluated the efficacy and safety of n-acetylcysteine (NAC) supplementation in males with infertility or impaired semen parameters. The analysis included 5 studies and found that NAC significantly improved sperm volume, concentration, total motility, and normal morphology without reported side effects.

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2024·ANZ journal of surgery·Amanda Koh, Tiffany Wong, Alfred Adiamah, et al

Systematic review and meta-analysis of the effect of N-acetylcysteine on outcomes after liver resection.

Meta-analysisn = 388

This meta-analysis examined the effectiveness of N-acetylcysteine (NAC) in improving outcomes following hepatectomy. Five RCTs with 388 patients were included. NAC was associated with lower post-operative lactate levels, but there were no significant differences in INR, ALT, length of stay, transfusion rates, or morbidity, suggesting limited effectiveness in reducing hepatic dysfunction.

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2024·Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology·Pu Yifu

A review of antioxidant N-acetylcysteine in addressing polycystic ovary syndrome.

Systematic reviewWomens Health

Systematic review investigating the potential benefits of N-acetylcysteine (NAC) in managing polycystic ovary syndrome (PCOS). The review analyzed over 100 research papers, suggesting NAC may counteract oxidative stress and offer anti-inflammatory and anti-apoptotic benefits, potentially influencing insulin signaling pathways.

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2024·The Laryngoscope·Patrick J Gaffney, Kunal R Shetty, Sancak Yuksel, et al

Antioxidant Therapies in the Treatment of Aminoglycoside-Induced Ototoxicity: A Meta-Analysis.

Meta-analysis

This meta-analysis examines the effectiveness of antioxidant therapies in treating aminoglycoside-induced ototoxicity. N-acetylcysteine and aspirin were found to be effective in reducing ototoxicity, while vitamin E did not show a significant effect. The analysis highlights the need for more high-quality studies to confirm these findings.

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2023·The British journal of nutrition·Zahra Shahveghar Asl, Karim Parastouei, Eslam Eskandari

The effects of N-acetylcysteine on ovulation and sex hormones profile in women with polycystic ovary syndrome: a systematic review and meta-analysis.

Meta-analysisn = 2,185Womens Health Hormone Health

Systematic review and meta-analysis of 18 studies with 2185 participants evaluating the effects of N-acetylcysteine (NAC) on ovulation and sex hormones in women with PCOS. NAC significantly reduced total testosterone levels and increased follicle-stimulating hormone levels, suggesting potential improvement in reproductive system function.

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2023·Frontiers in nutrition·Jiajun Liu, Haodong Su, Xueshan Jin, et al

The effects of N-acetylcysteine supplement on metabolic parameters in women with polycystic ovary syndrome: a systematic review and meta-analysis.

Systematic reviewn = 869Womens Health Nutrition

Systematic review and meta-analysis of 11 RCTs including 869 women with PCOS, examining the effects of N-acetylcysteine (NAC) on metabolic parameters. NAC showed improvements in fasting blood-glucose levels, total cholesterol, and other metabolic parameters compared to metformin and placebo, suggesting it may be a promising supplement for PCOS treatment.

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2023·Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology·Zaheer Nabi, Mohan Vamsi, Rajesh Goud, et al

Pre-medication with simethicone and N-acetyl cysteine for improving mucosal visibility during upper gastrointestinal endoscopy: A randomized controlled trial.

RCTn = 800

This randomized controlled trial assessed the impact of premedication with simethicone and N-acetyl cysteine (NAC) on mucosal visibility during upper gastrointestinal endoscopy. The study found that premedication with simethicone or a combination of simethicone and NAC significantly improved mucosal visibility compared to water or NAC alone.

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2022·Frontiers in pharmacology·Anna Licata, Maria Giovanna Minissale, Simona Stankevičiūtė, et al

N-Acetylcysteine for Preventing Acetaminophen-Induced Liver Injury: A Comprehensive Review.

Systematic reviewn = 19,580

Systematic review of 34 studies involving 19,580 patients on the use of N-Acetylcysteine (NAC) for preventing acetaminophen-induced liver injury. NAC was found to improve hepatotoxicity and reduce mortality, with efficacy dependent on timing of administration within 8 to 24 hours of overdose.

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2022·Psychiatry research·Xianrong Xu, Ge Shao, Xu Zhang, et al

The efficacy of nutritional supplements for the adjunctive treatment of schizophrenia in adults: A systematic review and network meta-analysis.

Meta-analysisn = 1,165

This systematic review and network meta-analysis evaluated the efficacy of nutritional supplements as adjunctive treatments for schizophrenia. It included 17 RCTs with 1165 participants, comparing folate acid or vitamin B12, vitamin D, N-acetyl cysteine (NAC), and omega-3 polyunsaturated fatty acids. NAC was found to be significantly more efficacious than folic acid or vitamin B12 and omega-3 fatty acids in terms of PANSS score changes, and it may be the most effective adjunctive intervention.

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2022·Translational psychiatry·Taro Kishi, Kenji Sakuma, Nakao Iwata

Mitochondrial modulators for obsessive-compulsive and related disorders: a systematic review and meta-analysis.

Meta-analysisn = 629Mental Clarity

Systematic review and meta-analysis of 17 studies (n=629) on mitochondrial modulators for obsessive-compulsive and related disorders. N-acetylcysteine showed significant improvement in overall symptoms compared to placebo, but no mitochondrial modulators outperformed placebo in improving anxiety-related scale scores.

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2022·Current reviews in clinical and experimental pharmacology·Muhammed Rashid, Viji Pulikkel Chandran, Sreedharan Nair, et al

N-Acetyl Cysteine in Rodenticide Poisoning: A Systematic Review and Meta-Analysis.

Meta-analysisn = 492

Systematic review and meta-analysis of 10 studies (2 RCTs, 4 observational, 4 descriptive) on N-Acetyl Cysteine (NAC) in rodenticide poisoning. Pooled RCT results showed significant recovery and reduced mortality with NAC. The review suggests NAC improves survival and reduces mortality in rodenticide poisoning cases.

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2022·Asian journal of psychiatry·Han Xu, Yang Du, Qiong Wang, et al

Comparative efficacy, acceptability, and tolerability of adjunctive anti-inflammatory agents on bipolar disorder: A systemic review and network meta-analysis.

Meta-analysisMood

Network meta-analysis comparing anti-inflammatory agents for bipolar disorder treatment. Adjunctive N-acetylcysteine (NAC) was superior to placebo for improving bipolar disorder symptoms. Coenzyme Q10 (CoQ10) showed a high response rate, and NSAIDs were favorable for remission rate. All agents had a good safety profile.

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2022·Addictive behaviors·Rishi Sharma, Sai Krishna Tikka, Ashish Ramesh Bhute, et al

N-acetyl cysteine in the treatment of cannabis use disorder: A systematic review of clinical trials.

Systematic reviewMental Clarity

Systematic review of RCTs evaluating N-acetyl cysteine (NAC) for treating cannabis use disorder (CUD). The review included 8 RCTs and found mixed results, with NAC showing effectiveness in promoting abstinence, medication adherence, and reducing cannabis use and craving.

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2021·Clinics and research in hepatology and gastroenterology·Dr Pritam Biswas, Dr Sukumar Tk

The efficacy of adjuvant N acetyl cysteine for the eradication of H pylori infections: A systematic review and meta-analysis of randomized clinical trials.

Meta-analysisn = 1,167

Systematic review and meta-analysis of randomized clinical trials evaluating the efficacy of adjuvant N acetyl cysteine (NAC) in the eradication of H. Pylori infections. The analysis included 8 studies with 1167 patients and found that adjuvant NAC plus standard treatment protocols are not superior to standard treatment protocols for H. pylori eradication.

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2021·The Cochrane database of systematic reviews·Jacob Hoffman, Taryn Williams, Rachel Rothbart, et al

Pharmacotherapy for trichotillomania.

Meta-analysisn = 286

This meta-analysis updates a Cochrane Review on the effects of medication for trichotillomania (TTM). It includes 12 studies, with preliminary evidence suggesting potential beneficial effects of N-acetylcysteine, clomipramine, and olanzapine in adults, though sample sizes were small and evidence certainty was low.

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2021·ANZ journal of surgery·Jack Cecire, Kristian Adams, Helen Pham, et al

Pharmacological prevention of post-operative pancreatitis: systematic review and meta-analysis of randomized controlled trials on animal studies.

Meta-analysis

Systematic review and meta-analysis of RCTs on animal models examining prophylactic treatment with corticosteroids or n-acetyl cysteine (NAC) for induced pancreatitis. NAC showed a significant reduction in severity of amylase and necrosis, while corticosteroids reduced markers of severity of pancreatitis.

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2021·Annals of hepatology·Dhan Bahadur Shrestha, Pravash Budhathoki, Yub Raj Sedhai, et al

N-acetyl cysteine versus standard of care for non-acetaminophen induced acute liver injury: a systematic review and meta-analysis.

Meta-analysis

Systematic review and meta-analysis evaluating the role of N-acetylcysteine (NAC) in non-acetaminophen induced acute liver injury (ALI). NAC showed a 53% reduction in mortality and a 59% lower rate of encephalopathy compared to standard care, but increased risk of nausea, vomiting, and need for mechanical ventilation.

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2021·Psychopharmacology·Rituparna Maiti, Archana Mishra, Biswa Ranjan Mishra, et al

Comparative efficacy of mitochondrial agents for bipolar disorder during depressive episodes: a network meta-analysis using frequentist and Bayesian approaches.

Meta-analysisMood -

Network meta-analysis evaluated the efficacy of mitochondrial agents in bipolar depression. N-acetylcysteine (NAC) was ranked highest in efficacy, followed by coenzyme Q10 and a combination of alpha-lipoic acid and acetyl-L-carnitine. However, none showed better efficacy than placebo in bipolar depression regarding depression rating scores.

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2020·Expert review of clinical pharmacology·Anupam Kumar Singh, Suhang Verma, Praveen Kumar-M, et al

Appropriate chemopreventive strategy for anti-tubercular therapy related liver injury is unsettled: Results from a systematic review and network meta-analysis.

Meta-analysis

Systematic review and network meta-analysis evaluating chemoprophylaxis agents for prevention of antitubercular therapy-related drug-induced liver injury (ATT-DILI). N-acetylcysteine appeared beneficial in preventing ATT-DILI, while Silymarin/Silibinin did not show significant benefit. Results were limited by potential bias and variability in study definitions.

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2019·Journal of psychopharmacology (Oxford, England)·Chun-Hung Chang, Hsien-Yuan Lane, Ping-Tao Tseng, et al

Effect of N-methyl-D-aspartate-receptor-enhancing agents on cognition in patients with schizophrenia: A systematic review and meta-analysis of double-blind randomised controlled trials.

Meta-analysisn = 1,951Mental Clarity

This meta-analysis reviewed 25 double-blind randomized controlled trials with 1951 participants to assess the effect of NMDA-receptor-enhancing agents on cognitive function in schizophrenia. Overall, NMDA-receptor-enhancing agents had a small but nonsignificant effect on cognition. However, N-acetyl cysteine (NAC) showed a significant positive effect on working memory.

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2018·Helicobacter·Yao-Bin Yang-Ou, Yi Hu, Yin Zhu, et al

The effect of antioxidants on Helicobacter pylori eradication: A systematic review with meta-analysis.

Meta-analysisn = 1,260Gut Health

This systematic review and meta-analysis evaluated the efficacy of adding antioxidants to triple or quadruple therapy for Helicobacter pylori eradication. The study included 9 studies with 1260 participants. The addition of antioxidants did not significantly improve eradication rates overall, but vitamin supplementation at high doses showed superior efficacy in certain subgroups. Antioxidant supplements did not affect side effects.

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2015·Clinical imaging·Muhammad Naeem, Gregory E McEnteggart, Timothy P Murphy, et al

Fenoldopam for the prevention of contrast-induced nephropathy (CIN)-do we need more trials? A meta-analysis.

Meta-analysisn = 719

Meta-analysis comparing intravenous Fenoldopam with Saline/Placebo/N-acetyl cysteine (NAC) for the prevention of contrast-induced nephropathy (CIN). The risk ratio for CIN development in the Fenoldopam group was 1.19 compared to the control group, which was not statistically significant. Fenoldopam is no better than Placebo/Saline or NAC in preventing CIN.

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2013·The Cochrane database of systematic reviews·Mathew Zacharias, Mohan Mugawar, G Peter Herbison, et al

Interventions for protecting renal function in the perioperative period.

Meta-analysisn = 4,378

This meta-analysis reviewed 72 randomized controlled trials involving 4378 participants to assess the effectiveness of various interventions, including N-acetyl cysteine, for protecting renal function during the perioperative period. The analysis found no reliable evidence that these interventions provide renal protection, with significant heterogeneity and methodological variability noted among the studies.

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2026·Acta medica Indonesiana·Fauzi Yusuf, Azzaki Abubakar, Desi Maghfirah

Efficacy and Safety of Pre-Endoscopy Regimens for Mucosal Visualization During Sedated Esophagogastro-duodenoscopy: A Randomized Controlled Trial.

RCTn = 168

RCT comparing four premedication regimens for mucosal visualization during sedated EGD in 168 patients. Simethicone and N-acetylcysteine given two hours before endoscopy enhanced mucosal visibility and procedural efficiency without compromising safety.

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2026·Clinical drug investigation·Sarah Sabry, Mai K Ammar, Mahmoud Taeima, et al

Preventing Contrast-Induced Acute Kidney Injury in Egyptian Patients Undergoing Coronary Angiography: A Randomized Controlled Trial.

RCTn = 120

RCT comparing the effect of high-dose N-acetylcysteine (NAC) plus hydration, high-dose atorvastatin plus hydration, or hydration alone on preventing contrast-induced acute kidney injury (CI-AKI) in 120 patients undergoing coronary angiography. NAC and statins reduced CI-AKI incidence, with statins showing more promising results.

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2026·Neurobiology of aging·Ethan Mah, Damien Gallagher, Fuqiang Gao, et al

Frontal white matter hyperintensity burden predicts cognitive response to N-acetylcysteine and exercise in vascular mild cognitive impairment.

RCTn = 58Brain Health

RCT involving 58 individuals with vascular mild cognitive impairment (vaMCI) receiving exercise therapy and randomized to N-acetylcysteine (NAC) or placebo. The study assessed executive function (EF) improvements using cognitive tests over 6 months. Lower baseline frontal WMH volume predicted greater improvement in TMT-B performance at 3 months in those treated with NAC versus placebo.

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2026·Drug delivery·Amirhossein Masroor, Nienke Streefkerk, Martine Van Grotel, et al

Local application of otoprotective compounds other than sodium thiosulfate to prevent cisplatin-induced hearing loss: a systematic review.

Systematic review

Systematic review investigating locally administered otoprotective agents other than sodium thiosulfate for preventing cisplatin-induced hearing loss in pediatric patients. Dexamethasone and n-acetylcysteine were identified as efficacious agents, with dexamethasone showing statistically significant but not clinically relevant benefits in some trials. Further research is needed on dosage, delivery method, and timing.

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2025·The Journal of clinical psychiatry·Sudie E Back, Kevin Gray, Amber M Jarnecke, et al

N-Acetylcysteine for the Treatment of Co-Occurring Posttraumatic Stress Disorder and Alcohol Use Disorder: A Double-Blind, Randomized Controlled Trial.

RCTn = 182Mental Clarity -Mood -

This randomized, double-blind, placebo-controlled trial examined the efficacy of N-acetylcysteine (NAC; 2,400 mg/day) among 182 individuals with co-occurring PTSD and alcohol use disorder. Both NAC and placebo groups showed significant reductions in PTSD symptoms and alcohol use, but there were no significant differences between the groups. NAC was well tolerated but not more effective than placebo.

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2025·East Asian archives of psychiatry : official journal of the Hong Kong College of Psychiatrists = Dong Ya jing shen ke xue zhi : Xianggang jing shen ke yi xue yuan qi kan·T Shruthi, L Govindan, S S Kanagarajan

Fluoxetine versus N-acetylcysteine in reducing craving in Indian men with alcohol dependence syndrome: a randomised controlled trial.

RCTn = 100Mental Clarity

RCT comparing fluoxetine and N-acetylcysteine (NAC) in reducing alcohol craving in 100 men with alcohol dependence syndrome. NAC showed greater reduction in craving scores, lower relapse rates, and better adherence compared to fluoxetine over 12 weeks.

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2025·Scientific reports·Anne Schienle, Sara Kohlhofer, Johannes Wilhelm, et al

A randomized crossover trial with experience sampling to test placebo effects on pathological skin-picking.

RCTn = 69Skin Hair Health Stress

Randomized crossover trial with 69 participants with pathological skin-picking (PSP) testing placebo effects using pills introduced as 'N-acetylcysteine'. Placebo treatment reduced skin-picking severity and perceived stress, with moderate reduction in the urge to engage in skin-picking observed during the second week of treatment.

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2025·International urology and nephrology·Iqbal Singh, Himanshu Agrawal, Shailender Maurya, et al

Efficacy and safety of N-acetylcysteine vs. probiotics in in-vivo biofilm prevention on ureteral stents: a prospective randomized controlled pilot in vivo study.

RCTn = 60

Prospective RCT comparing N-acetylcysteine (NAC) to probiotics for preventing biofilm formation on ureteral stents in 60 patients. NAC significantly reduced pyuria, positive urine cultures, and biofilm formation compared to probiotics, with no significant adverse effects observed.

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2025·World journal of gastroenterology·Preeyamas Koonsiripaiboon, Witchakorn Ruamtawee, Nitipon Simasingha, et al

Efficacy of N-acetylcysteinedexamethasone in preventing postembolization syndrome post-transarterial chemoembolization in hepatocellular carcinoma: A randomized controlled trial.

RCTn = 56

A randomized controlled trial comparing the efficacy of N-acetylcysteine (NAC) and dexamethasone (DEXA) in preventing postembolization syndrome (PES) in hepatocellular carcinoma patients undergoing transarterial chemoembolization. NAC significantly reduced the incidence of PES compared to DEXA, with no significant difference in liver function recovery between the groups.

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2025·Archives of Iranian medicine·Laya Hooshmand Gharabagh, Mehdi Heydaroghli, Ayda Esmaeili

Efficacy Of N-Acetyl-Cysteine as Adjuvant Therapy for Diabetic Foot Osteomyelitis: An Open-Label Randomized Controlled Trial.

RCTn = 53Inflammation

Open-label RCT assessing the efficacy of N-acetyl cysteine (NAC) as an adjuvant therapy for diabetic foot osteomyelitis. NAC 600 mg twice daily significantly reduced infectious-related laboratory parameters compared to control, accelerating the drop rate of ESR and CRP.

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2025·Clinical pharmacology in drug development·Xianmiao Yin, Rui Xia, Huan Song, et al

Pharmacokinetics and bioequivalence of two N-acetylcysteine tablets in healthy Chinese volunteers under fasting and fed conditions.

RCT

This study assessed the pharmacokinetics, bioequivalence, and safety of a domestically manufactured N-acetylcysteine (NAC) tablet compared with a reference formulation in healthy Chinese volunteers under fasting and fed conditions. The results demonstrated that the test and reference NAC tablets are bioequivalent and exhibit similar pharmacokinetic profiles and safety.

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2024·Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)·Jaqueline B Schuch, Fernanda Hansen, Thiago Hartmann, et al

A randomized, double-blind, placebo-controlled trial of N-acetylcysteine as an adjuvant treatment for alcohol use disorder.

RCTn = 53

A 9-week randomized, double-blind, placebo-controlled trial assessed N-acetylcysteine as an adjuvant treatment for alcohol use disorder in 53 inpatients. The study measured neuropeptide Y, oxidative stress, inflammatory biomarkers, and hepatic parameters. Both groups showed similar mean time to relapse, treatment adherence, and clinical improvement, with significant changes in hepatic biomarker levels over time.

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2024·Journal of cellular and molecular medicine·Marcin Sadowski, Emilia Zawieja, Agata Chmurzynska

The impact of N-acetylcysteine on lactate, biomarkers of oxidative stress, immune response, and muscle damage: A systematic review and meta-analysis.

Meta-analysisn = 20Physical Performance Inflammation Recovery

This systematic review and meta-analysis evaluated the effects of N-acetylcysteine (NAC) supplementation on various biomarkers after exercise. NAC significantly reduced muscle soreness, lactate, IL-6, and TBARS concentrations, and increased GSH levels, indicating potential benefits for recovery and inflammation post-exercise.

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2023·American journal of hematology·Yaqiong Tang, Ziyan Zhang, Silu Liu, et al

Conditioning therapy with N-acetyl-L-cysteine, decitabine and modified BUCY regimen for myeloid malignancies patients prior to allogeneic hematopoietic stem cell transplantation.

RCTn = 154

Prospective RCT assessing conditioning therapy with N-acetyl-L-cysteine (NAC), decitabine, and modified BUCY regimen in myeloid malignancies patients prior to hematopoietic stem cell transplantation. Arm A (with NAC and decitabine) showed accelerated platelet recovery and lower relapse incidence compared to Arm B (mBUCY only). The study suggests the addition of NAC and decitabine is a promising conditioning therapy.

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2023·Psychiatry research·Richard A Kanaan, Gina Oliver, Anita Dharan, et al

A multi-centre, double-blind, 12-week, randomized, placebo-controlled trial of adjunctive N-Acetylcysteine for treatment-resistant PTSD.

RCTn = 105Mental Clarity -

A multicentre, double-blind, randomized, placebo-controlled trial investigated the efficacy of adjunctive N-acetylcysteine (NAC) in treatment-resistant PTSD. No significant differences were found in PTSD symptoms between NAC and placebo groups at 12 weeks, but significant improvements in craving duration and resistance were observed at 64 weeks in favor of NAC.

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2023·Free radical biology & medicine·Hong Yang, Xiangyu Li, Han Jin, et al

Longitudinal metabolomics analysis reveals the acute effect of cysteine and NAC included in the combined metabolic activators.

RCTn = 70

Placebo-controlled study examining the acute effect of Combined Metabolic Activators (CMA) containing NAC or cysteine on metabolic pathways in 70 healthy volunteers. Metabolomics profiling showed high similarity in metabolic responses between CMA with nicotinamide and NAC or cysteine. CMA with cysteine was well-tolerated and safe.

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2023·Reviews on recent clinical trials·Bijan Heidari, Zeinab-Alsadat Seyedian, Maryam Mehrpooya, et al

N-Acetyl Cysteine as an Add-on Therapy is Useful in Treating Acute Lumbar Radiculopathy Caused by Disc Herniation: Results of a Randomized, Controlled Clinical Trial.

RCTn = 62Joint Bone Health

RCT of 62 patients with acute lumbar radiculopathy due to disc herniation, comparing NAC as an adjunct to NSAIDs versus placebo. From week 4 to week 8, the NAC group showed a significantly greater reduction in pain severity and disability scores compared to placebo. More NAC-treated patients achieved significant symptom improvement.

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2022·European review for medical and pharmacological sciences·V Kolarov, J Kotur Stevuljević, M Ilić, et al

Factorial analysis of N-acetylcysteine and propolis treatment effects on symptoms, life quality and exacerbations in patients with Chronic Obstructive Pulmonary Disease (COPD): a randomized, double-blind, placebo-controlled trial.

RCTn = 120

RCT assessing the efficacy and safety of orally administered N-acetylcysteine and propolis (NACp) in 120 COPD patients over 6 months. NACp treatment was found to be safe and beneficial for cough and expectoration symptoms, improving life quality and reducing acute exacerbation frequency.

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2022·BMC medicine·Yu Wang, Yuan Kong, Hong-Yan Zhao, et al

Prophylactic NAC promoted hematopoietic reconstitution by improving endothelial cells after haploidentical HSCT: a phase 3, open-label randomized trial.

RCTn = 120

A phase 3, open-label randomized trial investigated the efficacy and tolerability of N-acetyl-L-cysteine (NAC) prophylaxis in reducing poor graft function (PGF) or prolonged isolated thrombocytopenia (PT) after haploidentical hematopoietic stem cell transplantation (HSCT). The study found that NAC prophylaxis reduced the incidence of PGF and PT and improved bone marrow endothelial cells and CD34 cells, with no treatment-related deaths.

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2022·Progress in neuro-psychopharmacology & biological psychiatry·Jerome Sarris, Gerard Byrne, David Castle, et al

N-acetyl cysteine (NAC) augmentation in the treatment of obsessive-compulsive disorder: A phase III, 20-week, double-blind, randomized, placebo-controlled trial.

RCTn = 98Mental Clarity -

A phase III, 20-week, double-blind, randomized controlled trial investigated the safety and efficacy of adjunctive N-acetylcysteine (NAC) in 98 participants with OCD. The study found no evidence that NAC reduced OCD symptoms or improved secondary outcomes compared to placebo. NAC was well-tolerated with mild gastrointestinal adverse events.

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2022·The Journal of the Association of Physicians of India·Pratim Sengupta, Sumanta Biswas, Tapas Roy

Comparative Study to Evaluate the Effect of Low-Protein Diet Supplementation with Taurine and N-Acetylcysteine, N-Acetylcysteine and Pyridoxamine Dihydrochloride in Preventing the Progression of Chronic Renal Failure in Patients with Non-Diabetic Kidney Disease.

RCTn = 69

This randomized, open-label, controlled study evaluated the effect of N-acetylcysteine in combination with taurine and pyridoxamine on the progression of chronic renal failure in non-diabetic patients. The study found that the combination of N-acetylcysteine and pyridoxamine significantly improved eGFR compared to control, suggesting a positive effect on kidney health.

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2021·Journal of psychiatric research·Chiara C Bortolasci, Alyna Turner, Mohammadreza Mohebbi, et al

Baseline serum amino acid levels predict treatment response to augmentation with N-acetylcysteine (NAC) in a bipolar disorder randomised trial.

RCTn = 60Mood

This study is a secondary analysis of a 16-week, multi-site, randomized, double-blinded, placebo-controlled trial investigating N-acetylcysteine (NAC) as a treatment for bipolar disorder. Participants received either NAC 2000 mg/day or placebo. The study found that baseline serum amino acid levels could predict treatment response, with lower levels of certain amino acids associated with better response to NAC.

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2021·International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics·Shahrzad Aghaamoo, Azade Zandbina, Elham Saffarieh, et al

The effect of N-acetyl cysteine on the volume of uterine leiomyoma: A randomized clinical trial.

RCTn = 50Womens Health

RCT conducted in Semnan, Iran, to investigate the effect of N-acetyl cysteine (NAC) on uterine leiomyoma volume. 50 women with leiomyoma were randomized to receive NAC or placebo for 12 weeks. NAC group showed a significant reduction in leiomyoma volume compared to placebo.

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2020·Clinical infectious diseases : an official publication of the Infectious Diseases Society of America·M. S. Moosa, G. Maartens, H. Gunter, et al

A Randomized Controlled Trial of Intravenous N-acetylcysteine in the Management of Anti-tuberculosis Drug-Induced Liver Injury.

RCTn = 102

RCT assessing intravenous NAC in 102 hospitalized adults with anti-tuberculosis drug-induced liver injury. NAC did not shorten time to ALT <100 U/L but significantly reduced length of hospital stay. Adverse reactions led to early infusion stoppage in some participants.

Semantic ScholarRead on Semantic Scholar
2019·Psychological medicine·N Çakici, N J M van Beveren, G Judge-Hundal, et al

An update on the efficacy of anti-inflammatory agents for patients with schizophrenia: a meta-analysis.

Meta-analysisn = 270

Meta-analysis of 56 RCTs evaluating anti-inflammatory agents for schizophrenia symptoms. Significant efficacy was found for aspirin, estrogens, minocycline, and N-acetylcysteine (NAC), with larger effects in first-episode psychosis or early-phase schizophrenia.

PubMedRead on PubMed
2019·Pharmacological research·Phiwayinkosi V Dludla, Sithandiwe E Mazibuko-Mbeje, Tawanda M Nyambuya, et al

The beneficial effects of N-acetyl cysteine (NAC) against obesity associated complications: A systematic review of pre-clinical studies.

Systematic reviewInflammation Nutrition

Systematic review of pre-clinical studies assessing the therapeutic effect of N-acetylcysteine (NAC) against obesity-associated complications. The review supports NAC's ameliorative effects on inflammation, oxidative stress, lipid accumulation, and insulin sensitivity in in vitro and in vivo models.

PubMedRead on PubMed
2019·Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology·Yu Song, Huimin Wang, Hongli Huang, et al

Comparison of the efficacy between NAC and metformin in treating PCOS patients: a meta-analysis.

Meta-analysisWomens Health

Meta-analysis comparing the efficacy of N-acetyl-cysteine (NAC) and metformin in treating PCOS patients. NAC significantly reduced BMI and total testosterone, but showed no significant difference in pregnancy rate, serum LH level, fasting insulin, and LH/FSH ratio compared to metformin.

PubMedRead on PubMed
2018·Frontiers in Neurology·J. Bhatti, B. Nascimento, Umbreen Akhtar, et al

Systematic Review of Human and Animal Studies Examining the Efficacy and Safety of N-Acetylcysteine (NAC) and N-Acetylcysteine Amide (NACA) in Traumatic Brain Injury: Impact on Neurofunctional Outcome and Biomarkers of Oxidative Stress and Inflammation

Systematic reviewBrain Health Inflammation

Systematic review of human and animal studies examining the efficacy and safety of N-acetylcysteine (NAC) and N-acetylcysteine amide (NACA) in traumatic brain injury (TBI). The review found improvement in functional outcomes and reduction in biomarkers of inflammation and oxidative stress in animal studies, with limited human trials showing positive effects.

Semantic ScholarRead on Semantic Scholar
2018·American journal of cardiovascular drugs : drugs, devices, and other interventions·Phiwayinkosi V Dludla, Stephanie C Dias, Nnini Obonye, et al

A Systematic Review on the Protective Effect of N-Acetyl Cysteine Against Diabetes-Associated Cardiovascular Complications.

Systematic reviewHeart Health

Systematic review of studies on the cardioprotective potential of N-acetyl cysteine (NAC) against diabetes-associated cardiovascular complications. Most studies support NAC's ameliorative potential against oxidative stress and cardiac damage in diabetic patients. The review highlights the need for consistent dose selection and further research on NAC's comparative effects with glucose-lowering therapies.

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2016·Angiology·Sadeq Ali-Hasan-Al-Saegh, Seyed Jalil Mirhosseini, Zahra Ghodratipour, et al

Strategies Preventing Contrast-Induced Nephropathy After Coronary Angiography: A Comprehensive Meta-Analysis and Systematic Review of 125 Randomized Controlled Trials.

Meta-analysis

This meta-analysis and systematic review evaluated the effects of hydration, supplementations (N-acetylcysteine and vitamin C), and some drugs on contrast-induced nephropathy (CIN) after coronary angiography. The analysis found beneficial effects of sodium bicarbonate, N-acetylcysteine, and vitamin C in reducing the incidence of CIN.

PubMedRead on PubMed
2016·Cardiovascular therapeutics·Sadeq Ali- Hasan- Al- Saegh, Seyed Jalil Mirhosseini, Mahbube Tahernejad, et al

Impact of antioxidant supplementations on cardio-renal protection in cardiac surgery: an updated and comprehensive meta-analysis and systematic review.

Meta-analysisHeart Health Inflammation

This meta-analysis and systematic review evaluated the impact of antioxidant supplements like NAC, vitamin C, and PUFA on perioperative outcomes after cardiac surgery. NAC, vitamin C, and PUFA were associated with reduced incidence of atrial fibrillation, while NAC also significantly reduced acute kidney injury and overall mortality.

PubMedRead on PubMed
2016·Journal of clinical psychopharmacology·Louise Smith, Derek K Tracy, Giovanni Giaroli

What Future Role Might N-Acetyl-Cysteine Have in the Treatment of Obsessive Compulsive and Grooming Disorders?: A Systematic Review.

Systematic review

Systematic review of methodologically robust literature on the efficacy of n-acetyl-cysteine (NAC) for obsessive-compulsive spectrum disorders in adults and children. Four randomized, double-blind placebo-controlled studies were identified, but results remain inconclusive. NAC may be useful on an individual level due to its benign side-effect profile, but larger trials are needed to determine clinical effectiveness.

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2016·CNS drugs·Shaun E Gruenbaum, Alexander Zlotnik, Benjamin F Gruenbaum, et al

Pharmacologic Neuroprotection for Functional Outcomes After Traumatic Brain Injury: A Systematic Review of the Clinical Literature.

Systematic reviewBrain Health

Systematic review of clinical studies from 2013 to 2015 evaluating neuroprotective functional outcomes of pharmacological agents after TBI. N-acetyl cysteine (NAC) and other agents showed possible neuroprotective properties and improved functional outcomes in some studies.

PubMedRead on PubMed
2008·International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics·Ahmed Y Shahin, Ibrahim M A Hassanin, Alaa M Ismail, et al

Effect of oral N-acetyl cysteine on recurrent preterm labor following treatment for bacterial vaginosis.

RCTn = 280Womens Health

RCT of 280 pregnant women with previous preterm birth and bacterial vaginosis, comparing NAC plus 17-OHPC to placebo plus 17-OHPC. NAC group had a higher gestational age at delivery and reduced recurrence of preterm birth.

PubMedRead on PubMed
1999·Journal of toxicology. Clinical toxicology·N A Buckley, I M Whyte, D L O'Connell, et al

Oral or intravenous N-acetylcysteine: which is the treatment of choice for acetaminophen (paracetamol) poisoning?

Meta-analysisn = 981

Meta-analysis comparing the efficacy of intravenous versus oral N-acetylcysteine in treating acetaminophen poisoning. The study found similar outcomes for hepatotoxicity between the two administration routes, with intravenous N-acetylcysteine being preferable due to shorter hospital stays and convenience.

PubMedRead on PubMed
2026·Parkinsonism & related disorders·Daniel A Monti, George Zabrecky, Daniel Kremens, et al

N-Acetylcysteine is associated with changes in functional connectivity in patients with Parkinson's disease.

RCTn = 44Brain Health

RCT assessing the effects of N-Acetylcysteine (NAC) on functional connectivity in Parkinson's disease patients. NAC was associated with significant changes in functional connectivity between basal ganglia structures and other brain regions, correlating with improvements in Parkinson's symptoms.

PubMedRead on PubMed
2026·BMC oral health·Alaa Essam, Shahira El Domiaty, Nahed Attia, et al

N-acetylcysteine nano-spray versus conventional treatment in the management of radiotherapy-induced oral mucositis in oral cancer patients: a randomized clinical trial.

RCTn = 40Inflammation

RCT comparing N-acetylcysteine nano-spray to conventional therapy in 40 oral cancer patients with radiotherapy-induced oral mucositis. NAC nano-spray significantly reduced mucositis severity and improved quality of life compared to control, with increased serum gastrin-17 levels.

PubMedRead on PubMed
2026·Scientific reports·Zahra Sadat Heshmati, Amir Amiri-Yekta, Mona Khosravifar, et al

Administration of N-acetylcysteine influence the expression of apoptotic genes in the granulosa cells of infertile women diagnosed with endometriosis.

RCTn = 25Womens Health

This randomized controlled trial investigated the effects of N-acetylcysteine (NAC) on serum levels of superoxide dismutase (SOD) and total antioxidant capacity (TAC), as well as the expression of apoptotic genes in granulosa cells of infertile women with endometriosis. NAC treatment increased serum SOD and TAC levels, decreased the expression of pro-apoptotic genes Bax and Caspase-3, and increased the expression of the anti-apoptotic gene Bcl-2.

PubMedRead on PubMed
2025·Clinical biochemistry·Yubin Lei, Anik Forest, Caroline Daneault, et al

Correlation of plasma lipidomic profiles with cardiometabolic disease in transfusion-dependent thalassemia patients with six-month N-acetylcysteine intervention: A prospective cohort study.

Cohort studyn = 62Heart Health

Prospective cohort study of 62 Thai transfusion-dependent thalassemia patients evaluating the effect of a six-month N-acetylcysteine (NAC) intervention. NAC treatment significantly altered plasma lipidomic profiles and improved heart rate variability, suggesting a potential cardioprotective effect.

PubMedRead on PubMed
2025·Neuropsychopharmacology reports·Kristiane Yacou Dunbar, Gezelle Dali, Marilena M DeMayo, et al

The Effect of N-Acetylcysteine (NAC) on Neurometabolites and Cognitive Function in Adults With Alcohol Use Disorder: A Preliminary Randomized Controlled Trial.

RCTn = 23

Preliminary RCT examining the effect of N-acetylcysteine on brain neurometabolite levels and cognitive function in 23 adults with alcohol use disorder. No significant differences were found between the N-acetylcysteine and placebo groups in neurometabolite concentrations or cognitive scores.

PubMedRead on PubMed
2024·Alcohol and alcoholism (Oxford, Oxfordshire)·Nassima A-D Tiouririne, Tevfik Kalelioglu, Chamindi Seneviratne, et al

Safety and tolerability of topiramate and N-acetyl cysteine combination in individuals with alcohol use disorder: a 12 week, randomized, double-blind, pilot study.

RCTn = 17Mental Clarity -Mood

A 12-week, double-blind randomized trial assessed the effects of combining N-acetyl cysteine (NAC) with topiramate (TPM) versus TPM alone in individuals with alcohol use disorder. The study found no significant difference in cognitive adverse events or alcohol consumption between the treatment arms. However, the TPM+NAC group showed higher levels of automaticity of drinking and interference due to drinking compared to the TPM+Placebo group.

PubMedRead on PubMed
2024·Journal of pediatric gastroenterology and nutrition·P Babu Balagopal, Rohit Kohli, Vikas Uppal, et al

Effect of N-acetyl cysteine in children with metabolic dysfunction-associated steatotic liver disease-A pilot study.

RCTn = 13Inflammation Gut Health Hormone Health

A double-blind, placebo-controlled trial of N-acetyl cysteine (NAC) in 13 children with obesity and biopsy-confirmed MASLD over 16 weeks. NAC treatment improved markers of inflammation, oxidative stress, insulin resistance, and liver outcomes, but did not affect body weight or composition.

PubMedRead on PubMed
2023·Alcohol and alcoholism (Oxford, Oxfordshire)·Kirsten C Morley, Siena Peruch, Claire Adams, et al

N acetylcysteine in the treatment of alcohol use disorder: a randomized, double-blind, placebo-controlled trial.

RCTn = 42

A 28-day double-blind, placebo-controlled randomized trial of N-acetylcysteine (NAC) in the treatment of alcohol use disorder (AUD) with 42 participants. The study found no significant differences in treatment retention or primary clinical outcomes between NAC and placebo, though there was a significant time x treatment effect on standard drinks per drinking day. NAC was found to be feasible and safe, suggesting the need for a larger trial with a longer treatment duration to determine efficacy.

PubMedRead on PubMed
2023·Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology·Anna E Kirkland, Brittney D Browning, ReJoyce Green, et al

N-acetylcysteine does not alter neurometabolite levels in non-treatment seeking adolescents who use alcohol heavily: A preliminary randomized clinical trial.

RCTn = 31

This double-blind, placebo-controlled, within-subjects crossover preliminary investigation measured changes in neurometabolite levels in the dACC using proton magnetic resonance spectroscopy during 10-days of N-acetylcysteine compared to placebo in non-treatment seeking adolescents who use alcohol heavily. No significant differences in Glx, GABA, or glutathione levels were found, nor were there measurable effects on alcohol use.

PubMedRead on PubMed
2023·Revista medica del Instituto Mexicano del Seguro Social·Goretti Del Carmen Rosas-Gutiérrez, Juan Pablo Fernández-Hernández, Atzin Itaí Olea-González

[Efficacy of intratympanic infiltration of N-acetyl cysteine in cisplatin ototoxicity].

RCTn = 22

Open, longitudinal, prospective, randomized clinical trial in cancer patients treated with cisplatin to evaluate the efficacy of intratympanic NAC infiltration for preventing and treating ototoxicity. Out of 22 patients, 11 received NAC infiltration and 11 were controls. Results showed that NAC infiltration may reduce the risk of hearing loss progression compared to controls.

PubMedRead on PubMed
2023·Medicina (Kaunas, Lithuania)·Lorena A Cervantes-Pérez, Gabino Cervantes-Guevara, Enrique Cervantes-Pérez, et al

Evaluation of the Effects of Atorvastatin and N-Acetyl Cysteine on Platelet Counts in Patients with Primary Immune Thrombocytopenia: An Exploratory Clinical Trial.

RCTn = 15

Exploratory clinical trial evaluating the combination of atorvastatin and N-acetyl cysteine in increasing platelet counts in patients with immune thrombocytopenia resistant to steroid therapy. The study included 15 patients, with a global response rate of 60%. Significant increases in platelet counts were observed in the responder group.

PubMedRead on PubMed
2023·Nutricion hospitalaria·Elena Garicano Vilar, Sara Sanz Rojo, Sara López Oliva, et al

Effect of MetioNac® in patients with metabolic syndrome who are at risk of metabolic dysfunction associated fatty liver disease: a randomized controlled trial.

RCTn = 15Heart Health Nutrition

RCT evaluating the effect of MetioNac supplementation in patients with metabolic syndrome at risk of MAFLD. The supplement led to significant reductions in triglycerides, VLDL-c, total cholesterol, LDL-c, and glucose levels, and increased HDL-c levels compared to the control group. Weight loss was observed in both groups.

PubMedRead on PubMed
2022·Psychiatry research. Neuroimaging·Yvonne S Yang, Richard J Maddock, Huailin Zhang, et al

N-Acetylcysteine effects on glutathione and glutamate in schizophrenia: A preliminary MRS study.

RCTn = 40

Double-blind, randomized, placebo-controlled preliminary study of 40 patients with schizophrenia or schizoaffective disorder receiving 2400 mg NAC daily or placebo for eight weeks. NAC treatment was associated with increased glutathione and decreased glutamate in the medial prefrontal cortex, but no effects on symptoms or cognition were observed.

PubMedRead on PubMed
2022·Annals of surgery·Jin Vivian Lee, Connor Engel, Shirli Tay, et al

Impact of N-Acetyl-Cysteine on Ischemic Stumps Following Major Lower Extremity Amputation: A Pilot Randomized Clinical Trial.

RCTn = 33Inflammation

Pilot RCT evaluating the impact of intravenous N-acetyl-cysteine (NAC) on amputation stump perfusion and healing in patients with critical limb-threatening ischemia. NAC administration showed improved stump perfusion and healing in high-risk patients with perfusion defects, compared to placebo.

PubMedRead on PubMed
2021·Clinical and translational science·James W Dear, Mei Li Ng, D Nicholas Bateman, et al

A metabolomic analysis of thiol response for standard and modified N-acetyl cysteine treatment regimens in patients with acetaminophen overdose.

RCTn = 45

This study evaluated the redox thiol response and acetaminophen metabolites in patients with acetaminophen overdose treated with either a 20.25-hour standard or 12-hour modified N-acetylcysteine regimen. The modified regimen resulted in a significant elevation of plasma NAC and cysteine concentrations at 12 hours post-infusion, suggesting greater antioxidant efficacy.

PubMedRead on PubMed
2021·Annals of clinical and translational neurology·Kristen M Krysko, Antje Bischof, Bardia Nourbakhsh, et al

A pilot study of oxidative pathways in MS fatigue: randomized trial of N-acetyl cysteine.

RCTn = 15Energy -

Pilot RCT assessing feasibility, tolerability, and safety of N-acetyl cysteine (NAC) for fatigue in progressive MS. NAC was well-tolerated, but reduction in fatigue was similar to placebo. Antioxidant biomarkers were not significantly altered by NAC.

PubMedRead on PubMed
2020·Advances in therapy·Alberto Papi, Andrea F D Di Stefano, Milko Radicioni

Pharmacokinetics and Safety of Single and Multiple Doses of Oral N-Acetylcysteine in Healthy Chinese and Caucasian Volunteers: An Open-Label, Phase I Clinical Study.

RCTn = 30

Open-label, phase I clinical study evaluating the pharmacokinetics and safety of oral N-acetylcysteine (NAC) in 15 Chinese and 15 Caucasian healthy volunteers. Pharmacokinetic characteristics were similar between the two groups, with NAC showing a rapid increase in plasma concentration and a favorable tolerability profile.

PubMedRead on PubMed
2020·Current rheumatology reviews·Samrad Mehrabi, Maryam M Moradi, Zohre Khodamoradi, et al

Effects of N-acetylcysteine on Pulmonary Functions in Patients with Systemic Sclerosis: A Randomized Double Blind, Placebo Controlled Study.

RCTn = 25

This randomized double-blind clinical trial assessed the effect of N-acetylcysteine (NAC) on pulmonary function in 25 patients with diffuse systemic sclerosis. The study found no significant differences in plethysmography parameters between the NAC and placebo groups over 24 weeks, indicating NAC had no effect on pulmonary function.

PubMedRead on PubMed
2019·International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics·Ibrahim A El Sharkwy, Walled M Abd El Aziz

Randomized controlled trial of N-acetylcysteine versus l-carnitine among women with clomiphene-citrate-resistant polycystic ovary syndrome.

RCTn = 162Womens Health Hormone Health Nutrition

RCT comparing N-acetylcysteine and l-carnitine in women with clomiphene-citrate-resistant PCOS. Both substances improved pregnancy and ovulation rates, but N-acetylcysteine was superior in improving insulin resistance, while l-carnitine improved lipid profile.

PubMedRead on PubMed
2019·Clinical oral investigations·Ahlam Al-Kamel, Wadhah Abdulnaser Al-Hajj, Esam Halboub, et al

N-acetyl cysteine versus chlorhexidine mouthwashes in prevention and treatment of experimental gingivitis: a randomized, triple-blind, placebo-controlled clinical trial.

RCTn = 60Inflammation

Randomized, triple-blind, placebo-controlled clinical trial comparing N-acetyl cysteine (NAC) and chlorhexidine (CHX) mouthwashes in prevention and treatment of experimental gingivitis in 60 subjects. NAC showed slight preventive properties and marginal effectiveness in treatment, while CHX was more effective in reducing plaque and gingivitis.

PubMedRead on PubMed
2019·Annals of Saudi medicine·Manal El Hamamsy, Rasha Bondok, Sara Shaheen, et al

Safety and efficacy of adding intravenous N-acetylcysteine to parenteral L-alanyl-L-glutamine in hospitalized patients undergoing surgery of the colon: a randomized controlled trial.

RCTn = 60Inflammation -

RCT investigating the efficacy and tolerability of intravenous N-acetylcysteine (NAC) as an antioxidant and anti-inflammatory agent in 60 patients undergoing colon surgery. NAC administration was safe, but its efficacy was not statistically significant, requiring further investigation.

PubMedRead on PubMed
2019·Journal of intensive care medicine·Arash Peivandi Yazdi, Majid Razavi, Shahrzad Sheikh, et al

Clinical Trial Assessment of Intermittent and Continuous Infusion Dose of N-Acetylcysteine on Redox Status of the Body in Patients with Sepsis Admitted to the ICU.

RCTn = 60Inflammation

A randomized clinical trial assessed the antioxidative effect of N-acetylcysteine (NAC) in 60 critically ill sepsis patients, comparing intermittent and continuous infusion regimens. NAC increased total antioxidant capacity and decreased malondialdehyde levels in both infusion groups compared to placebo, with no significant difference between the infusion methods.

PubMedRead on PubMed
2019·The Journal of dermatological treatment·Esam Halboub, Baleegh Alkadasi, Mohammed Alakhali, et al

N-acetylcysteine versus chlorhexidine in treatment of aphthous ulcers: a preliminary clinical trial.

RCTn = 58Inflammation

This preliminary clinical trial compared the efficacy of N-acetylcysteine (NAC) to chlorhexidine in treating recurrent aphthous stomatitis (RAS) in 58 patients. NAC showed a greater reduction in pain associated with RAS compared to chlorhexidine, although there were no significant differences in ulcer size change or healing time.

PubMedRead on PubMed
2019·Reproductive biology and endocrinology : RB&E·Rahil Jannatifar, Kazem Parivar, Nasim Hayati Roodbari, et al

Effects of N-acetyl-cysteine supplementation on sperm quality, chromatin integrity and level of oxidative stress in infertile men.

RCTn = 50Sexual Health Hormone Health

RCT of 50 infertile men with asthenoteratozoospermia receiving 600mg/day N-acetyl-cysteine for 3 months. NAC supplementation improved sperm count, motility, morphology, DNA integrity, and hormonal profile, with increased testosterone and decreased FSH and LH levels. Oxidative stress markers showed increased total antioxidant capacity and decreased malondialdehyde.

PubMedRead on PubMed
2018·Schizophrenia research·Alan Breier, Emily Liffick, Tom A Hummer, et al

Effects of 12-month, double-blind N-acetyl cysteine on symptoms, cognition and brain morphology in early phase schizophrenia spectrum disorders.

RCTn = 60Brain Health Mental Clarity

A 52-week double-blind, placebo-controlled trial assessed the effects of N-acetyl cysteine (3600mg/day) on symptoms and cognition in early phase schizophrenia spectrum disorders. NAC significantly improved PANSS total, negative, and disorganized thought symptom scores but failed to improve PANSS positive symptoms and BACS cognitive scores. NAC did not significantly impact brain morphology over the study period.

PubMedRead on PubMed
2018·Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association·Virendra Singh, Amarjit Keisham, Ashish Bhalla, et al

Efficacy of Granulocyte Colony-Stimulating Factor and N-Acetylcysteine Therapies in Patients With Severe Alcoholic Hepatitis.

RCTn = 57

RCT comparing standard medical therapy with pentoxifylline to G-CSF and NAC in patients with severe alcoholic hepatitis. G-CSF improved liver function and survival times, but adding NAC showed no additional benefit.

PubMedRead on PubMed
2018·Acta neuropsychiatrica·Bruna Panizzutti, Chiara Bortolasci, Kyoko Hasebe, et al

Mediator effects of parameters of inflammation and neurogenesis from a N-acetyl cysteine clinical-trial for bipolar depression.

RCT

This study is a secondary analysis of a placebo-controlled randomized trial exploring the effects of adjunctive N-acetyl cysteine (NAC) treatment on markers of inflammation and neurogenesis in bipolar depression. The study found no significant changes in levels of BDNF, TNF-α, CRP, IL-6, IL-8, or IL-10, and no mediation or moderation effects of these biological factors on clinical parameters.

PubMedRead on PubMed
2017·Progress in neuro-psychopharmacology & biological psychiatry·Zahra Sepehrmanesh, Mahsa Heidary, Negar Akasheh, et al

Therapeutic effect of adjunctive N-acetyl cysteine (NAC) on symptoms of chronic schizophrenia: A double-blind, randomized clinical trial.

RCTn = 84Mental Clarity Mood

This 12-week double-blind, randomized, placebo-controlled clinical trial evaluated the effectiveness of 1200mg N-acetyl cysteine as an adjunctive treatment with conventional antipsychotic medications in 84 patients with chronic schizophrenia. NAC-treated patients showed significant improvement in positive and negative PANSS subscales, as well as cognitive functions such as attention, memory, and executive functioning.

PubMedRead on PubMed
2017·Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica·Giovanni Palleschi, Antonio Carbone, Pier Paolo Zanello, et al

Prospective study to compare antibiosis versus the association of N-acetylcysteine, D-mannose and Morinda citrifolia fruit extract in preventing urinary tract infections in patients submitted to urodynamic investigation.

RCTn = 80Immunity -

Prospective RCT comparing the administration of D-mannose, N-acetylcysteine, and Morinda citrifolia extract versus antibiotic therapy in preventing UTIs in patients undergoing urodynamic examination. No significant difference in UTI incidence was found between the two groups, suggesting these nutraceuticals may be a viable alternative to antibiotics for UTI prophylaxis.

PubMedRead on PubMed
2016·Acta oto-laryngologica·Chao-Hsien Chen, Yi-Ho Young

N-acetylcysteine as a single therapy for sudden deafness.

RCTn = 70

RCT comparing N-acetylcysteine (NAC) as a single therapy to corticosteroids and plasma expander in 70 patients with sudden deafness. Group A (NAC) showed significantly greater mean hearing gain and improved rate of hearing compared to Group B.

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2016·Reproduction, fertility, and development·Ebrahim Cheraghi, Malek Soleimani Mehranjani, Mohammad Ali Shariatzadeh, et al

N-Acetylcysteine improves oocyte and embryo quality in polycystic ovary syndrome patients undergoing intracytoplasmic sperm injection: an alternative to metformin.

RCTn = 60Womens Health

A prospective randomized placebo-controlled pilot study on 60 Iranian women with PCOS undergoing intracytoplasmic sperm injection. The study compared the effects of metformin, N-acetylcysteine (NAC), and their combination on oocyte and embryo quality. NAC improved oocyte and embryo quality, decreased malondialdehyde and leptin levels, and could be an alternative to metformin.

PubMedRead on PubMed
2016·PloS one·Daniel A Monti, George Zabrecky, Daniel Kremens, et al

N-Acetyl Cysteine May Support Dopamine Neurons in Parkinson's Disease: Preliminary Clinical and Cell Line Data.

RCTBrain Health Physical Performance

This study assessed the effects of n-acetyl-cysteine (NAC) in Parkinson's disease using both in vitro and in vivo approaches. NAC exposure increased survival of dopamine neurons in cell cultures and improved dopamine transporter binding and clinical symptoms in PD patients, suggesting potential protective effects.

PubMedRead on PubMed
2015·Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology·Ahmed M Maged, Heba Elsawah, Aly Abdelhafez, et al

The adjuvant effect of metformin and N-acetylcysteine to clomiphene citrate in induction of ovulation in patients with Polycystic Ovary Syndrome.

RCTn = 120Womens Health

RCT of 120 women with PCOS comparing clomiphene citrate (CC) alone, CC plus NAC, and CC plus metformin. NAC as an adjuvant to CC improved ovulation and pregnancy rates with beneficial impacts on endometrial thickness.

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2015·Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology·Forough Javanmanesh, Maryam Kashanian, Maryam Rahimi, et al

A comparison between the effects of metformin and N-acetyl cysteine (NAC) on some metabolic and endocrine characteristics of women with polycystic ovary syndrome.

RCTn = 94Womens Health Hormone Health Nutrition

Randomized double-blind clinical trial comparing N-acetyl cysteine (NAC) and metformin in women with PCOS over 24 weeks. NAC improved lipid profile, fasting blood sugar, and fasting blood insulin better than metformin.

PubMedRead on PubMed
2015·Current opinion in pediatrics·Angela Hernández-Martín, Rogelio González-Sarmiento

Recent advances in congenital ichthyoses.

Systematic review

The review provides an update on molecular and clinical findings in congenital ichthyosis, highlighting recent advances in understanding genetic causes and emerging treatments. N-acetylcysteine has been added to the therapeutic options, and topical enzyme replacement therapy is a promising alternative for TG1-deficient individuals.

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