N-Acetylcysteine in the Treatment of Craving in Substance Use Disorders: Systematic Review and Meta-Analysis

N-Acetylcysteine in the Treatment of Craving in Substance Use Disorders: Systematic Review and Meta-Analysis

Author Duailibi, Michel Silvio Google Scholar
Cordeiro, Quirino Autor UNIFESP Google Scholar
Brietzke, Elisa Autor UNIFESP Google Scholar
Ribeiro, Marcelo Autor UNIFESP Google Scholar
LaRowe, Steve Google Scholar
Berk, Michael Google Scholar
Trevizol, Alisson Paulino Google Scholar
Abstract Background and Objectives: Recent neurobiological evidences along with clinical observations justify the use of N-acetylcysteine (NAC) as a medication for craving. The objective of our study was to assess the evidence of efficacy of NAC for craving in substance use disorders in randomized clinical trials (RCTs). Methods: Systematic review of the RCTs literature (PROSPERO number 56698) until February, 2017, using MEDLINE, Cochrane Library and clinicaltrials.gov. We included seven RCTs (n = 245)

most with small-to-moderate sample sizes. The main outcome was the Hedges' g for continuous scores in a random-effects model. Heterogeneity was evaluated with the I-2 and the chi(2) test. Publication bias was evaluated using the Begg's funnel plot and the Egger's test. Meta-regression was performed using the random-effects model. Results: Comparing NAC versus placebo, NAC was significantly superior for craving symptoms (Hedges' g = 0.94

95% CI 0.55-1.33). The funnel plot showed the risk of publication bias was low and between-study heterogeneity was not significant (I-2 = 44.4%, p = 0.07 for the chi(2) test). A subgroup analysis performed using meta-regression showed no particular influence. Discussion and Conclusions: NAC was superior to placebo for craving reduction in SUDs. The relatively small number of trials and their heterogeneous methodology were possible limitations

however, these positive thrilling results stimulate further studies for clarifying the potential impact of NAC for craving symptoms in SUDs. Scientific Significance: The safety profile of NAC and favorable tolerability, in addition to being an over-the-counter medication, presents with an interesting potential clinical use for craving in SUDs. Scientific Significance: The safety profile of NAC and its favorable tolerability, in addition to being anover-the-counter medication, presents with an interesting potential clinical use for craving in SUDs.
xmlui.dri2xhtml.METS-1.0.item-coverage Hoboken
Language English
Sponsor NHMRC
Date 2017
Published in American Journal On Addictions. Hoboken, v. 26, n. 7, p. 660-666, 2017.
ISSN 1055-0496 (Sherpa/Romeo, impact factor)
Publisher Wiley
Extent 660-666
Origin http://dx.doi.org/10.1111/ajad.12620
Access rights Closed access
Type Article
Web of Science ID WOS:000417558400001
URI https://repositorio.unifesp.br/handle/11600/57188

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