An open-label trial of N-acetylcysteine for the treatment of cocaine dependence: A pilot study

• Published in: Progress in neuro-psychopharmacology & biological psychiatry Vol. 31; no. 2; pp. 389 - 394
• Main Authors: Mardikian, Pascale N., LaRowe, Steven D., Hedden, Sarra, Kalivas, Peter W., Malcolm, Robert J.
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Inc 30.03.2007; Elsevier
• Subjects: Acetylcysteine - adverse effects; Acetylcysteine - therapeutic use; Adolescent; Adult; Biological and medical sciences; Cocaine dependence; Cocaine-Related Disorders - drug therapy; Dose-Response Relationship, Drug; Female; Free Radical Scavengers - adverse effects; Free Radical Scavengers - therapeutic use; Humans; Male; Medical sciences; Middle Aged; N-acetylcysteine; Neuropharmacology; Open-label trial; Pharmacology. Drug treatments; Pilot Projects; Pilot study; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease); Psychology. Psychoanalysis. Psychiatry; Psychopharmacology; Treatment Outcome; Cocaine dependence; Pilot study; Open-label trial; N-acetylcysteine; Human; Thiol; CNS stimulant; Psychotropic; Acetylcysteine; Ester; Treatment; Dependence; Cocaine; Drug of abuse
• ISSN: 0278-5846; 1878-4216
• DOI: 10.1016/j.pnpbp.2006.10.001

Recent preclinical studies implicate N-acetylcysteine (NAC), a cysteine prodrug, as a potential medication for preventing relapse to cocaine use; however, little is known about the safety and tolerability of NAC in cocaine-dependent subjects in an outpatient setting. This pilot study examines the safety and tolerability of 3 doses of NAC for the treatment of cocaine dependence. Twenty three treatment-seeking cocaine-dependent patients participated in a 4-week medication trial and received NAC at doses of 1200 mg/day, 2400 mg/day or 3600 mg/day. Results suggested that the three doses were well tolerated. Overall, the retention rates appeared to favor higher doses of NAC (2400 mg/day and 3600 mg/day). The majority of subjects who completed the study ( n = 16) either terminated use of cocaine completely or significantly reduced their use of cocaine during treatment. Overall the findings suggest that it is feasible to treat cocaine-dependent treatment seekers with N-acetylcysteine on an outpatient basis.