Open AccessN-Acetylcysteine as a novel rapidly acting anti-suicidal agent: A pilot naturalistic study in the emergency setting
Author(s) -
Davinder Hans,
Anthony Rengel,
Jaspreet Hans,
Darryl Bassett,
Sean Hood
Publication year - 2022
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0263149
Subject(s) - acetylcysteine , major depressive disorder , adjunctive treatment , medicine , emergency department , schizophrenia (object oriented programming) , suicidal ideation , clinical global impression , depression (economics) , psychiatry , rating scale , bipolar disorder , poison control , psychology , injury prevention , emergency medicine , developmental psychology , biochemistry , chemistry , cognition , alternative medicine , pathology , economics , macroeconomics , antioxidant , placebo
Objective N-acetylcysteine has a demonstrated role as an adjunctive therapy in psychotic and affective disorders as a treatment to reduce symptoms of Bipolar Affective Disorder, Major Depressive Disorder and Schizophrenia. However, its potential as a rapidly acting anti-suicidal agent has not yet been assessed. This naturalistic study evaluates its effect in thirty patients presenting following intentional medication overdose. Methods Eighteen patients who ingested toxic doses of paracetamol received NAC whilst twelve other patients with other overdoses received standard supportive treatment in the emergency department setting. Symptoms were measured using the Montgomery-Asberg Depression Rating Scale and Clinical Global Impression scale at time of presentation, 24 hours, and seven days. Results Baseline characteristics between groups were similar. Both groups showed a significant reduction in suicidality, as measured by the suicide item of the MADRS, over time ( p 32) compared to the ‘NAC group’ ( p = 0.044). Conclusion This naturalistic study suggests NAC may have potential use as a rapidly acting treatment adjunct in major depressive disorder, warranting further investigation of its effects.