Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands. l.schmaal @ amc.uva.nl
Eur Addict Res. 2011;17(4):211-6. doi: 10.1159/000327682. Epub 2011 May 24.
Relapse is the rule rather than the exception in smokers aiming to quit smoking. Recently, evidence has emerged that glutamate transmission plays an important role in relapse. N-acetylcysteine (NAC), a cysteine prodrug, restores glutamate homeostasis and appears to be a potential new treatment for substance dependence. In the current pilot study, the effects of NAC on short-term abstinence of smoking were investigated. Subjects were heavy smokers randomized to receive placebo (n = 12) or NAC 3,600 mg/day (n = 10) in a double-blind fashion during 3.5 days. Subjects were asked to stop smoking and report on nicotine craving, nicotine withdrawal symptoms, and cigarette smoking during treatment. At the end of the treatment, subjects were invited to smoke a cigarette and to rate the rewarding effect of this cigarette. There was no significant effect of NAC on craving (p = 0.23, d = 0.52) and only a statistical trend towards fewer withdrawal symptoms in the NAC condition (p = 0.07, d = 0.80). Interestingly, subjects receiving NAC rated the first cigarette after the abstinence period of 3.5 days as significantly less rewarding than subjects on placebo (p = 0.04, d = 0.85). It is concluded that the results of this pilot study are encouraging and suggest that NAC might be a promising new treatment option for relapse prevention in nicotine dependence.
在试图戒烟的吸烟者中，复吸是常态而非例外。最近有证据表明，谷氨酸传递在复吸中起着重要作用。N-乙酰半胱氨酸（NAC）是一种半胱氨酸前体药物，可恢复谷氨酸的动态平衡，似乎是治疗物质依赖的一种有潜力的新方法。在当前的初步研究中，研究了 NAC 对吸烟短期戒断的影响。将重度吸烟者随机分为两组，接受安慰剂（n = 12）或 NAC 3600mg/天（n = 10）的双盲治疗，为期 3.5 天。要求受试者停止吸烟，并报告尼古丁渴望、尼古丁戒断症状和吸烟情况。在治疗结束时，邀请受试者吸烟，并对这支烟的奖赏效果进行评分。NAC 对渴望（p = 0.23，d = 0.52）和戒断症状（p = 0.07，d = 0.80）均无显著影响，仅呈现出 NAC 条件下的戒断症状减少的趋势。有趣的是，接受 NAC 的受试者在为期 3.5 天的戒断期后，将第一支烟的评价显著低于安慰剂组（p = 0.04，d = 0.85）。因此，可以得出结论，这项初步研究的结果令人鼓舞，并表明 NAC 可能是预防尼古丁依赖复吸的一种有前途的新治疗选择。
