N-acetylcysteine for treating cocaine addiction - A systematic review.

Abstract:

:The aim of this paper is to extensively review the current literature available on N-acetylcysteine (NAC) treatment for cocaine dependence (clinical and experimental studies). We screened all articles published before February 2016 reporting on the use of NAC as a pharmacological intervention for cocaine dependence or discussed its potential as a therapeutic approach for cocaine dependence. We described our results qualitatively. 21 studies matched our search criteria: 6 clinical trials and 15 animal studies. Four clinical studies showed NAC's capacity to reduce craving, desire to use cocaine, cocaine-cue viewing-time and cocaine-related spending. Studies in animal models also support this reinstatement prevention application of NAC. NAC reverses the disruption of glutamate homeostasis caused by long-term cocaine use restoring function of the cystine-glutamate exchanger in glial cells and reversing the downregulated GLT-1 receptor. Current data suggest promising potential for NAC as an anti-relapse agent, as a double-blind placebo trial was mainly negative, except in the subgroup of patients who were already abstinent. An optimal dose for relapse prevention may be one that restores extrasynaptic glutamate to physiological levels and predominantly activates mGluR2 and 3, but not mGluR5 receptors, which are linked to relapse. NAC may be better suited for avoiding relapse in already abstinent subjects.

journal_name

Psychiatry Res

journal_title

Psychiatry research

authors

Nocito Echevarria MA,Andrade Reis T,Ruffo Capatti G,Siciliano Soares V,da Silveira DX,Fidalgo TM

doi

10.1016/j.psychres.2017.02.024

subject

Has Abstract

pub_date

2017-05-01 00:00:00

pages

197-203

eissn

0165-1781

issn

1872-7123

pii

S0165-1781(16)30886-1

journal_volume

251

pub_type

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