Evidence supporting the use of: N-acetyl-cysteine (NAC)
For the health condition: Alcoholism

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Synopsis

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

N-acetyl-cysteine (NAC) has been investigated for its potential role in supporting the treatment of alcoholism and alcohol use disorder (AUD), but the evidence base remains limited and preliminary. NAC is a precursor to glutathione, a key antioxidant in the brain, and is thought to modulate glutamatergic and dopaminergic neurotransmission, both of which are implicated in addiction and cravings. Preclinical studies in animals have shown that NAC can reduce alcohol-seeking behavior and relapse-like drinking, possibly by restoring glutamate homeostasis in the nucleus accumbens, a brain region involved in reward and addiction.

In humans, a few small clinical trials and case reports have explored NAC’s effects on alcohol craving and consumption. For example, a 2018 double-blind, placebo-controlled trial (Nocito Echevarria et al., 2018) found no significant difference in alcohol consumption or craving between NAC and placebo over 12 weeks, though the study was limited by a small sample size. Other studies have suggested that NAC may reduce cravings in other substance use disorders (such as cocaine or cannabis), but its efficacy for alcohol remains inconclusive.

Overall, while NAC’s pharmacological rationale for use in alcoholism is supported by basic science studies, robust clinical evidence in humans is lacking. Thus, it is not a standard or widely accepted treatment for alcoholism, and more high-quality clinical trials are needed to establish its efficacy and safety in this context.

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