Effects of N-Acetyl-Cysteine on Neurocognition in a double-blind randomized placebo-controlled trial
Poster B37, Friday, October 21, 11:30 am - 1:00 pm, Le Baron
Larry Seidman1, Philippe Conus1, Margot Fournier1, Cleusix Martine1, Lijing Xin1, Philipp Bauman1, Carina Ferrari;1, Ann Cousins1, Luis Alameda1, Mehdi Gholam-Rezaee1, Philippe Golay1, Raoul Jenni1; 1Harvard Medical School, 2Lausanne University Hospital, 3School of Pharmaceutical Sciences, University of Geneva, 4Laboratory of Functional and Metabolic Imaging, Ecole Polytechnique Fédérale de Lausanne, 5McLean Hospital, 6Massachusetts Mental Health Center, 7Beth Israel Deaconess Medical Center
Objective: Neurocognitive impairments are widespread in the early phases of psychosis and interfere with social and role functioning. Cognitive enhancement with remediation has been moderately successful, but thus far, pharmacological interventions have been largely negative. We explored the impact of addition of N-Acetyl-Cysteine (NAC) to standard anti-psychotic treatment in early psychosis (EP) patients on neurocognition. Methods: Double-blind, randomized, placebo-controlled trial of addition of NAC, 2700 mg daily, to antipsychotic treatment over 6 months. Neurocognition was assessed at baseline and at the end of 6 months of treatment with the MATRICS Consensus Cognitive Battery (MCCB) excluding the MSCEIT. The sample was comprised of 36 patients with psychotic illnesses (20 NAC, 16 placebo), largely schizophrenia spectrum disorders, with less than 8 years of illness. Results: There was no significant difference in an overall cognition score. All 6 factors showed absolute improvement in the NAC group while only 3/6 improved in absolute terms in Placebo. There was a significant interaction showing improvement in Processing Speed/PS (NAC > Placebo; F(1, 30)=5.849, p=.022), with the interaction favoring NAC on 2 of 3 PS tasks (Trail Making A, F(1, 30)=4.279, p=.048 and Verbal Fluency, F(1, 30)=5.749, p=.023). Moreover, NAC improved PS in a sub-group of patients having a low basal peroxidase activity (GPx). Conclusions: While addition of NAC did not produce an overall improvement in cognition, it did significantly improve Processing Speed and this was related to low GPX. Future, larger studies on antioxidant interventions in EP are needed to replicate these findings.
Topic Area: Neurocognition