Evaluation of the effect of N-acetylcysteine in patients with generalized anxiety disorder

Abstract

Generalized Anxiety Disorder (GAD) is one of the most common anxiety disorders that is characterized by persistent and excessive worry about a number of different things. Recently, several studies of anxiety-spectrum disorders in adults have noted increased central glutamate concentrations, and glutamatergic hyperactivity is implicated in the pathophysiology of anxiety disorders. N-acetylcysteine (NAC), is glutamate modulator that increases extrasynaptic glutamate and, in doing so, stimulates inhibitory metabotropic glutamate receptors and decreases synaptic glutamate. This decrease in synaptic glutamate has been hypothesized to confer benefit in anxiety treatment. Objective: Comparison of the effect of N-acetylcysteine and standard treatment on anxiety score in patients with generalized anxiety disorder

Methods: This clinical trial enrolled 100 patients with GAD, aged between 18 to 65 years. Patients were randomly assigned to two groups. a case group which received N-acetylcysteine (600 mg) and standard treatment on anxiety score; and a control group which received only standard treatment on anxiety score for 8 weeks. Assessments, comprising the HAMILTON Questionnaire score were conducted by a psychiatrist at baseline and then at 4, 8 weeks after the medication was started using repeated measure analysis. To achieve this goal, 100 patients were assigned to this pilot study. Using Hamilton anxiety questionnaire, we determined the level of anxiety of the patients. The first group did not receive N-acetylcysteine and the second group received the drug. Then, in the 8th week of the study, the anxiety level was re-measured by a questionnaire and compared with the second group.

Results: Improvement and decrease in Hamilton score were observed in both groups but N-acetylcysteine decreased the HAMILTON score In the case group, more than control group. Conclusion: Simultaneous administration of N-acetylcysteine with routine pharmacotherapy of GAD is more effective than standard treatment used alone.