N-Acetylcysteine Eases Depression in Bipolar Disorder

Physicians often have difficulty treating depression in people with bipolar disorder, formerly called manic-depression. Both depression and bipolar disorder are often accompanied with low levels of glutathione, a key antioxidant made by the body.

Ashley I. Bush, MD, PhD, of the Mental Health Research Institute of Victoria, Australia, and his colleagues decided to use a glutathione precursor and antioxidant, N-acetylcysteine (NAC), to treat patients with bipolar disorder.

“We hypothesized that add-on NAC treatment may also be of clinical benefit in both the treatment and prevention of depressive symptoms in bipolar disorder, which are characteristically difficult to treat...” wrote Bush.

Seventy-five patients were treated with either 1 gram of NAC or placebos twice daily for six months, in addition to their regular medications.

By the end of the study, patients benefited from a significant reduction in symptoms of depression, the primary end point of the study. They also had clear improvements in most of the study’s secondary end points, including functioning and overall quality of life. There was also a trend toward reduced manic symptoms.

“N-acetylcysteine is relatively inexpensive, of established safety, and available over the counter,” noted Bush.

References: Berk M, Copolov DL, Dean O, et al. “N-acetylcysteine for depressive symptoms in bipolar disorder – a double-blind randomized placebo-controlled trial.” Biological Psychiatry, 2008; doi 10.1016/j.biopsych.2008.04.022.