Does oral N-acetyl-cysteine (NAC) improve schizophrenia symptoms?

ISRCTN ISRCTN61794329
DOI https://doi.org/10.1186/ISRCTN61794329
Secondary identifying numbers 13/08
Submission date
08/09/2009
Registration date
14/10/2009
Last edited
14/10/2009
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Mental and Behavioural Disorders
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English Summary

Not provided at time of registration

Study website

Contact information

Dr Philippe Conus
Scientific

Département de Psychiatrie
Route de Cery
Prilly
1008
Switzerland

Email philippe.conus@chuv.ch

Study information

Study designRandomised multicentre parallel double-blind placebo-controlled trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Participant information sheet Can be found at http://www.chuv.ch/psychiatrie/dpc_home/dpc_infos_organisation/dpc_cnp/dpc_cnp_schizo.html
Scientific titleEffects of oral N-acetyl-cysteine (NAC) in the early phase of schizophrenia spectrum psychosis: a randomised parallel double-blind placebo-controlled trial
Study hypothesisN-acetyl-cysteine (NAC), a common antitussive drug, is able to modulate the response to oxidative stress in body tissues. The aim of the study is to evaluate the impact of oral administration of NAC in the early phase of schizophrenia, on clinical, psychopathological, neuropsychological, biochemical and neuro-physiological variables.

1. Symptomatology: does the oral administration of NAC have an impact on evolution of positive and negative symptoms, cognitive deficits?
2. Side effects of neuroleptic treatment: does the oral administration of NAC have an impact on the side effects of antipsychotic treatment?
3. Glutathione (GSH) level: does the oral administration of NAC increase the plasma and brain concentration of GSH and related compounds?
4. Mismatch negativity (MMN): does the oral administration of NAC have an impact on MMN, a pre-attentive component of electro-encephalograms found to be impaired in schizophrenic patients?
Ethics approval(s)The Faculty of Biology and Medicine - Ethics Commission of Clinical Research (Faculté de Biologie et de Médecine - Commission d'éthique de la recherche clinique) approved on the 10th July 2008 (ref: 13/08)
ConditionEarly phase psychosis
InterventionEach patient gets 2700 mg NAC or placebo per day during 24 weeks. Each patient gets the NAC pills/placebo each month for four weeks. After 24 weeks we stop the NAC/placebo and there is a follow-up after 4 weeks. Then we do the last clinical interviews and take urine and blood samples.
Intervention typeDrug
Pharmaceutical study type(s)
PhasePhase II
Drug / device / biological / vaccine name(s)N-acetyl-cysteine (NAC)
Primary outcome measureImprovement of the negative symptoms, measured with the Positive and Negative Syndrome Scale (PANSS - score: 1 = absence of the symptom to 7 = extreme symptoms), measured at baseline, then every month for 7 months
Secondary outcome measures1. Clinical outcome: decreased risk of relapse during the outcome period measured with the PANSS, GAF and SOFAS)
2. Neuropsychological outcome: improvement of cognition (measured with the global score of the "MATRICS" battery); and improvement of the working memory (measured with the "MATRICS" battery)
3. Functional electroencephalographic outcome: improvement of the MMN (or prevention/delay); change of the P3, response to visual stimuli
4. Magnetic resonance by spectroscopy (MRS): higher cerebral level of glutathione measured by MRS. Changes in connectivity measured by MRS and DSI, diffusion spectrum imaging. Measured at baseline (V1) and after 6 months.
5. Stratification: better response to treatment in sub-groups (high-risk/low risk GCLC genotype and/or anomalies in GSH system)
Overall study start date15/12/2008
Overall study end date30/11/2011

Eligibility

Participant type(s)Patient
Age groupAdult
SexBoth
Target number of participants40
Participant inclusion criteria1. Capability to provide informed consent
2. Male or female aged 15 to 35 years with sufficient command of French language
3. Having met threshold criteria for psychosis as defined by the "Psychosis threshold" subscale of the Comprehensive Assessment of at Risk Mental States Scale (CAARMS). This threshold is based on a combination of intensity and duration of psychotic symptoms.
Participant exclusion criteria1. Severe somatic comorbidities: peptic ulcer disease, chronic inflammatory pathologies, infectious pathologies including human immunodeficiency virus (HIV), pathologies of the immune system, organic cerebral diseases, tumours, abnormal renal, hepatic, thyroid or haematological findings
2. Previous cerebral trauma
3. Substance induced psychosis or organic psychosis
4. Mental retardation (intellectual quotient [IQ] less than 70 and alteration or significant adaptation deficit). We will assess the IQ only in the case of necessity when we doubt about the intellectual skills of a patient.
5. NAC allergy
6. Treatment with antioxidants (vitamin E, selenium, multivitamins, etc.)
7. Insufficient command of French
Recruitment start date15/12/2008
Recruitment end date30/11/2011

Locations

Countries of recruitment

  • Switzerland
  • United States of America

Study participating centre

Département de Psychiatrie
Prilly
1008
Switzerland

Sponsor information

Swiss National Science Foundation (Fonds National Suisse de la Recherche Scientifique [SNSF]) (Switzerland)
Research organisation

SNSF 2009
Wildhainweg 3
PO Box 8232
Berne
CH-3001
Switzerland

Phone +41 (0)31 308 22 22
Email kim.do@chuv.ch
Website http://www.snf.ch/E/Pages/default.aspx
ROR logo "ROR" https://ror.org/00yjd3n13

Funders

Funder type

Charity

Lausanne University Hospital, faculté de Biologie et de Médecine (CHUV) (Switzerland) - MTR Schizophrénie

No information available

Society of the French-Swiss Lottery (Loterie Romande) (Switzerland)

No information available

Swiss National Science Foundation (SNSF) (Switzerland)
Private sector organisation / Trusts, charities, foundations (both public and private)
Alternative name(s)
Schweizerischer Nationalfonds, Swiss National Science Foundation, Fonds National Suisse de la Recherche Scientifique, Fondo Nazionale Svizzero per la Ricerca Scientifica, Fonds National Suisse, Fondo Nazionale Svizzero, Schweizerische Nationalfonds, SNF, SNSF, FNS
Location
Switzerland
Stanley Thomas Johnson Foundation (Switzerland)

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 01/08/2008 Yes No
Results article results 01/09/2008 Yes No