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Effects of N-acetylcysteine on substance use in bipolar disorder: a randomised placebo-controlled clinical trial

  • Michelle Bernardo (a1), Seetal Dodd (a1), Clarissa S. Gama (a2), David L Copolov (a3) (a4), Olivia Dean (a1) (a3), Kristy Kohlmann (a1) (a3), Susan Jeavons (a3), Ian Schapkaitz (a3), Murray Anderson-Hunt (a3), Ashley I Bush (a3) and Michael Berk (a1) (a5) (a3)...



To evaluate the effect of N-acetylcysteine (NAC) on substance use in a double-blind, placebo-controlled trial of NAC in bipolar disorder. It is hypothesised that NAC will be superior to placebo for reducing scores on the Clinical Global Impressions scale for Substance Use (CGI-SU).


Participants were randomised to 6-months of treatment with 2 g/day NAC (n = 38) or placebo (n = 37). Substance use was assessed at baseline using the Habits instrument. Change in substance use was assessed at regular study visits using the CGI-SU.


Amongst the 75 participants 78.7% drank alcohol (any frequency), 45.3% smoked tobacco and 92% consumer caffeine. Other substances were used by fewer than six participants. Caffeine use was significantly lower for NAC-treated participants compared with placebo at week 2 of treatment but not at other study visits.


NAC appeared to have little effect on substance use in this population. A larger study on a substance using population will be necessary to determine if NAC may be a useful treatment for substance use.


Corresponding author

Dr Seetal Dodd Department of Clinical and Biomedical Sciences: Barwon Health, The University of Melbourne, PO Box 281, Geelong 3220, Australia. Tel: +61 3 5226 7666; Fax: +61 3 5246 5165; E-mail:


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Effects of N-acetylcysteine on substance use in bipolar disorder: a randomised placebo-controlled clinical trial

  • Michelle Bernardo (a1), Seetal Dodd (a1), Clarissa S. Gama (a2), David L Copolov (a3) (a4), Olivia Dean (a1) (a3), Kristy Kohlmann (a1) (a3), Susan Jeavons (a3), Ian Schapkaitz (a3), Murray Anderson-Hunt (a3), Ashley I Bush (a3) and Michael Berk (a1) (a5) (a3)...


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