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Clinical Treatment of Addictive Disorders with N-Acetylcysteine

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The Therapeutic Use of N-Acetylcysteine (NAC) in Medicine

Abstract

Addictive behaviors and substance use disorders are important psychiatric disorders with limited effective pharmacotherapies. One of the major neurobiological mechanisms of addiction involves glutamate neurotransmission. N-Acetylcysteine (NAC) is increasingly being evaluated as a glutamate modulator with particular effects on the same neurobiological mechanisms that are involved in addiction. Both preclinical and clinical studies support the use of NAC in the treatment of addiction. This chapter reviews the relevant clinical literature with focus on addiction to cannabis, cocaine, methamphetamine, nicotine, and gambling. Overall evidence supports NAC affecting glutamate neurotransmission in addictive disorders. Clinically, NAC has had mixed success as a cessation treatment, but may be more efficacious as a relapse prevention aid, given preliminary clinical findings and preclinical work in this area. Given the favorable safety and tolerability profile of NAC, it may be a promising therapy for the treatment of addiction.

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Authors and Affiliations

  1. Department of Psychology, Arizona State University, Tempe, AZ, USA

    Gregory Powell, M. Foster Olive & Cassandra D. Gipson

  2. Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA

    Erin A. McClure

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  1. Gregory Powell
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  2. Erin A. McClure
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  3. M. Foster Olive
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  4. Cassandra D. Gipson
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Correspondence to Gregory Powell .

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Editors and Affiliations

  1. Barrow Neurological Institute, Phoenix Children’s Hospital, University of Arizona, College of Medicine – Phoenix, Phoenix, AZ, USA

    Richard Eugene Frye

  2. IMPACT SRC, Deakin University & Barwon Health, Geelong, VIC, Australia

    Michael Berk

1 Electronic Supplementary Material

Supplementary Table 13.1

Cocaine use disorder (DOCX 19 kb)

Supplementary Table 13.2

Cannabis use disorder (DOCX 18 kb)

Supplementary Table 13.3

Methamphetamine use disorder (DOCX 17 kb)

Supplementary Table 13.4

Tobacco use disorder (DOCX 20 kb)

Supplementary Table 13.5

Gambling disorder (DOCX 17 kb)

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Powell, G., McClure, E.A., Foster Olive, M., Gipson, C.D. (2019). Clinical Treatment of Addictive Disorders with N-Acetylcysteine. In: Frye, R., Berk, M. (eds) The Therapeutic Use of N-Acetylcysteine (NAC) in Medicine. Adis, Singapore. https://doi.org/10.1007/978-981-10-5311-5_13

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