Chen Alexander T, Chibnall John T, Nasrallah Henry A
Department of Psychiatry, Saint Louis University School of Medicine, St. Louis, MO USA.
Ann Clin Psychiatry. 2016 Aug;28(3):190-6.
Several studies have reported that schizophrenia is associated with mitochondrial abnormalities, glutathione deficit, and increased brain oxidative stress (free radicals). N-acetylcysteine (NAC) is a strong antioxidant with potential therapeutic benefit in schizophrenia, according to some reports. We conducted a review of the published controlled studies, with the goal of determining the efficacy profile of NAC as an adjunctive treatment for schizophrenia.
An online search was conducted for all placebo-controlled, double-blind, randomized clinical trials of NAC in schizophrenia, and a review was conducted.
Two studies met the criteria for inclusion. Berk et al (2008) used NAC as an adjunctive treatment to atypical antipsychotics in subjects with chronic schizophrenia who were stable on antipsychotic medications. Treatment at 8 weeks was less efficacious than placebo, but at 24 weeks produced significant reductions vs placebo in Positive and Negative Syndrome Scale (PANSS) negative (d = 0.52), general (d = 0.46), and total (d = 0.57) scores. Farokhnia et al (2013) used NAC as an adjunctive treatment to risperidone in subjects with chronic schizophrenia who were experiencing an acute exacerbation episode. Eight weeks of treatment led to clinically significant reductions vs placebo in PANSS negative (d = 0.96), general (d = 0.59), and total (d = 0.88) scores.
The data suggest that adjunctive NAC may be efficacious in reducing negative and general symptoms in schizophrenia.
多项研究报告称，精神分裂症与线粒体异常、谷胱甘肽缺乏以及大脑氧化应激（自由基）增加有关。据一些报告称，N-乙酰半胱氨酸（NAC）是一种强大的抗氧化剂，对精神分裂症可能具有治疗益处。我们对已发表的对照研究进行了综述，目的是确定NAC作为精神分裂症辅助治疗的疗效概况。
对所有关于NAC治疗精神分裂症的安慰剂对照、双盲、随机临床试验进行了在线搜索，并进行了综述。
两项研究符合纳入标准。伯克等人（2008年）在抗精神病药物治疗稳定的慢性精神分裂症患者中，将NAC用作非典型抗精神病药物的辅助治疗。8周治疗时的疗效不如安慰剂，但在24周时，与安慰剂相比，阳性和阴性症状量表（PANSS）的阴性（d = 0.52）、一般（d = 0.46）和总分（d = 0.57）得分显著降低。法罗赫尼亚等人（2013年）在经历急性加重发作的慢性精神分裂症患者中，将NAC用作利培酮的辅助治疗。8周治疗后，与安慰剂相比，PANSS的阴性（d = 0.96）、一般（d = 0.59）和总分（d = 0.88）得分在临床上显著降低。
数据表明，辅助使用NAC可能对减轻精神分裂症的阴性和一般症状有效。
