The N-acetylcysteine Story: A New Potential Therapy for Bipolar Illness and Substance Abuse
N-acetylcysteine (NAC), a readily available substance from health food stores, is able to reestablish glutamate homeostasis (regulation and balance) in the reward area of brain (the nucleus accumbens), reported Peter Kalivas of the University of South Carolina at the “Staging neuropsychiatric disorders: Implications for idiopathogenesis and treatment” meeting in Mojacar, Spain this past November. Kalivas reported that NAC appears to be effective across a spectrum of addictions, including cocaine, heroin, alcohol, cigarette smoking, and gambling.
How NAC works in the brain
Even more remarkably, NAC also appears to have positive effects in placebo-controlled studies in the treatment of patients with bipolar illness, report Mike Berk and colleagues, who are studying the same substance in Australia. Compared with placebo, patients taking adjunctive NAC showed improvement in all outcome measures, especially depression, after 3 and 6 months. In another article, also published in Biological Psychiatry in 2008, Berk’s research group demonstrated that NAC improved some negative symptoms of schizophrenia. NAC has also shown positive effects in trichotillomania and on nail-biting, suggesting that it has a variety of potential clinical uses in conditions associated with pathological compulsive behavioral patterns.
More Medical Comorbidities Among Bipolar Population
Goldstein and colleagues interpreted data from the National Epidemiological Survey in 2001-2002 that included 41,682 representative adults in the U.S. population sampled compared with 1,411 found in the community with a diagnosis of bipolar disorder.
Those with bipolar disorder had a 3.86 times higher odds of having coronary heart disease compared with those in the general population. They were also 2.15 times more likely to have hypertension. Most disturbingly, the mean age of those with coronary heart disease in the general population was 62.1 years of age, but in those with bipolar illness, it was 50.4 years of age. This indicates that the markedly increased risk and incidence of coronary artery disease occurred approximately 11 years earlier in those with bipolar illness compared with those without. Most interestingly, the number of prior depressive episodes correlated with the presence of either coronary heart disease or hypertension.
