Synopsis

Source of validity: Scientific
Rating (out of 5): 2

N-acetyl-cysteine (NAC) is an antioxidant and a precursor to the amino acid cysteine, traditionally used in treating acetaminophen toxicity and as a mucolytic agent. Its use in psychiatric and neurological disorders, including anxiety disorders, has emerged in recent years based on its ability to modulate glutamatergic neurotransmission and reduce oxidative stress—both factors implicated in the pathophysiology of anxiety. Several small-scale randomized controlled trials and open-label studies have investigated NAC for anxiety symptoms, often as an adjunct to standard treatments. Some studies report a modest reduction in anxiety symptoms, particularly in conditions where anxiety co-occurs with other disorders such as obsessive-compulsive disorder (OCD), bipolar disorder, or schizophrenia. A handful of meta-analyses and systematic reviews have noted potential benefits but generally conclude that evidence is still preliminary, inconsistent, and limited by small sample sizes and heterogeneity in study designs. Major clinical guidelines do not yet endorse NAC for primary treatment of anxiety disorders, and more robust, large-scale trials are needed. Overall, while the scientific rationale and early findings are promising, the evidence supporting NAC’s use for anxiety disorders remains limited and is best characterized as emerging rather than well established.

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Products containing N-acetyl-cysteine (NAC)

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