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

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dc.contributor.author Duailibi, Michel Silvio
dc.contributor.author Cordeiro, Quirino [UNIFESP]
dc.contributor.author Brietzke, Elisa [UNIFESP]
dc.contributor.author Ribeiro, Marcelo [UNIFESP]
dc.contributor.author LaRowe, Steve
dc.contributor.author Berk, Michael
dc.contributor.author Trevizol, Alisson Paulino
dc.date.accessioned 2020-08-04T13:39:56Z
dc.date.available 2020-08-04T13:39:56Z
dc.date.issued 2017
dc.identifier http://dx.doi.org/10.1111/ajad.12620
dc.identifier.citation American Journal On Addictions. Hoboken, v. 26, n. 7, p. 660-666, 2017.
dc.identifier.issn 1055-0496
dc.identifier.uri https://repositorio.unifesp.br/handle/11600/57188
dc.description.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) en
dc.description.abstract 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 en
dc.description.abstract 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 en
dc.description.abstract 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. en
dc.description.sponsorship NHMRC
dc.format.extent 660-666
dc.language.iso eng
dc.publisher Wiley
dc.relation.ispartof American Journal On Addictions
dc.rights Acesso restrito
dc.title N-Acetylcysteine in the Treatment of Craving in Substance Use Disorders: Systematic Review and Meta-Analysis en
dc.type Artigo
dc.description.affiliation Santa Casa Sch Med Sci, Sao Paulo, Brazil
dc.description.affiliation Univ Fed Sao Paulo, Dept Psychiat, Sao Paulo, Brazil
dc.description.affiliation Sao Paulo State Secretariat Hlth, Reference Ctr Alcohol Tobacco & Other Drugs CRATO, Rua Prates 165, BR-01121000 Sao Paulo, SP, Brazil
dc.description.affiliation Med Univ South Carolina, Ctr Drug & Alcohol Programs, Dept Psychiat, Charleston, SC USA
dc.description.affiliation Deakin Univ, IMPACT Strateg Res Ctr, Sch Med, Geelong, Vic, Australia
dc.description.affiliation Univ Melbourne, Florey Inst Neurosci & Mental Hlth, Dept Psychiat, Parkville, Vic, Australia
dc.description.affiliation Univ Melbourne, Orygen Youth Hlth Res Ctr, Parkville, Vic, Australia
dc.description.affiliationUnifesp Univ Fed Sao Paulo, Dept Psychiat, Sao Paulo, Brazil
dc.identifier.doi 10.1111/ajad.12620
dc.description.source Web of Science
dc.identifier.wos WOS:000417558400001
dc.coverage Hoboken
dc.citation.volume 26
dc.citation.issue 7



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