N-acetylcysteine (NAC) for methamphetamine dependence: A randomised controlled trial.

Area of Science:

• Addiction research
• Neuroscience
• Pharmacology

Background:

• Methamphetamine dependence is a global health issue with no approved medications.
• N-acetylcysteine (NAC), a cysteine prodrug, shows potential in modulating glutamate pathways relevant to addiction.
• Previous research suggests NAC may reduce craving for various substances.

Purpose of the Study:

• To evaluate the efficacy and safety of N-acetylcysteine (NAC) as a pharmacotherapy for individuals dependent on methamphetamine.
• To determine if NAC reduces methamphetamine use and associated clinical outcomes.

Main Methods:

• A 12-week, double-blind, randomized placebo-controlled trial involving 153 participants with methamphetamine dependence.
• Participants received either 2400 mg/day of oral NAC or a placebo.
• Primary outcomes included changes in days of methamphetamine use and methamphetamine-positive oral fluid samples; secondary outcomes assessed craving, dependence severity, withdrawal, and psychiatric symptoms.

Main Results:

• Both NAC and placebo groups showed significant reductions in methamphetamine use, with no significant difference between them.
• NAC did not significantly reduce methamphetamine-positive oral fluid samples compared to placebo.
• No significant improvements were observed for craving, dependence severity, withdrawal symptoms, or psychiatric symptoms in the NAC group relative to placebo.

Conclusions:

• Oral N-acetylcysteine (NAC) administered as a take-home medication did not demonstrate a significant effect on methamphetamine use.
• The study findings suggest NAC is not an effective treatment for methamphetamine dependence based on the evaluated outcomes.
• Adverse events were comparable between the NAC and placebo groups, indicating a similar safety profile.