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Harm Reduction Medication: N-acetyl-cysteine

*This post is for psychoeducation purposes only - it does not constitute medical advice *



N-acetylcysteine, or NAC, is an amino acid that is widely available as an over-the-counter antioxidant supplement. There is good research evidence that supports the use of NAC to help reduce craving for adults who struggle with substance use disorders, particularly cocaine, and helps prevent relapse in those who are abstinent. In addition, it has shown to be helpful in reducing body-focused repetitive behaviours such as obsessive skin picking (skin excoriation disorder) and hair pulling (trichitillomania) at dosages of 600-1200mg twice daily, with or without SSRI treatment.

Taken orally, it crosses the blood-brain barrier and helps to increase the brain’s production or glutathione. Glutathione is an antioxidant that reduces the effects of oxidative stress which is present in many psychiatric conditions and causes inflammatory reactions. Although research shows that NAC is safe and well-tolerated, ask your physician before starting self-treatment, especially if you take other medications or supplements.

References

Duailibi, M. S., Cordeiro, Q., Brietzke, E., Ribeiro, M., LaRowe, S., Berk, M., & Trevizol, A. P. (2017). N-acetylcysteine in the treatment of craving in substance use disorders: Systematic review and meta-analysis. American Journal on Addictions, 26(7), 660–666.

Jastrzębska, J., Frankowska, M., Filip, M., & Atlas, D. (2016). N-acetylcysteine amide (AD4) reduces cocaine-induced reinstatement. Psychopharmacology, 233(18), 3437–3448

Ooi, S. L., Green, R., & Pak, S. C. (2018). N-Acetylcysteine for the Treatment of Psychiatric Disorders: A Review of Current Evidence. BioMed Research International, 1–8.

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