pilladvised

by Jonathan Galland

Are you having trouble stopping yourself from smoking tobacco or marijuana, or from drinking too much alcohol, snorting cocaine, gambling compulsively, pulling out your hair or engaging in other addictive or compulsive behaviors?

Sometimes quitting may seem just about impossible.

You know there is a growing interest in vitamins and dietary supplements for all types of benefits. Shouldn’t there be something natural that can help?

Scientists are studying an antioxidant for treatment of impulsive/compulsive and addictive symptoms. It’s called N-acetyl-cysteine and is abbreviated as NAC.

What is N-acetyl-cysteine (NAC)?

NAC is an amino acid; it is a protein that is a building block of glutathione, considered to be the most important antioxidant in the body. Glutathione plays a key role in fighting oxidative stress and in detoxification, the process by which the body removes toxins.

Read Dr. David Perlmutter’s How Antioxidants Fight Aging

Taking NAC has been shown to increase the levels of glutathione in cells. In addition NAC has its own ability to reduce oxidative stress, according to research from the University of Arizona Health Science Center.

The Science of NAC

A recent review in the journal Innovations in Clinical Neuroscience described the rationale for the use of NAC to treat behavioral problems and psychiatric disorders, including depression, which involves oxidative stress in the brain, and compulsions or addictions, which involve malfunction of the brain’s reward systems.

NAC for Compulsive/Impulsive Symptoms

Repetitive acts that seek some type of reward are governed by the actions of another amino acid called glutamate. Malfunction of the brain’s glutamatergic system has been linked to addiction. Treatment with NAC is being investigated to determine if it can restore normal glutamate function in the brain.

After NAC is absorbed in the intestines, it passes through the blood to the brain where it is converted to cysteine, yet another amino acid that enhances the response of nerve cells to glutamate. As complex as this chain of events may sound, a series of NAC clinical trials is underway.

Clinical Trials on NAC

Tobacco Smoking

A small placebo- controlled study led by researchers from the Medical University of South Carolina looked at the effect of 2400 mg. per day of NAC on nicotine-dependent smokers. They found that those taking NAC reported that they smoked fewer cigarettes. The results were published in the journal Biological Psychiatry.

Read: Quitting Boosts Quality of Life

Marijuana

In another study, also led by researchers from the Medical University of South Carolina, 24 marijuana dependent users who wanted to cut back took 2400 mg per day of NAC. The drug users reduced their frequency and quantity of marijuana use. Interestingly, they also reported a decline in compulsive feelings regarding their marijuana use.

Publishing their findings in The American Journal on Addictions the authors conclude: “Results from this preliminary open-label study indicate that treatment with NAC was well tolerated and associated with significant decreases in self-report measures of marijuana use and craving. These reductions parallel those noted in prior NAC treatment studies in cocaine and nicotine dependent individuals.”

More: Cannabis Speeds Mental Illness?

Cocaine

A study of 23 cocaine dependent users taking NAC for four weeks found that 70 percent discontinued or significantly reduced their cocaine use.

In a double-blind placebo-controlled clinical trial, 13 cocaine addicts who took NAC 800 milligrams per day during three days of cocaine withdrawal reported a significant reduction in cocaine cravings and withdrawal symptoms when compared to the placebo group.

Presenting their findings in The American Journal on Addictions in 2006, the authors explain: “At the present time, there is no effective FDA-approved treatment for cocaine dependence, despite over two decades of intense research. A pharmacological treatment that could serve as an effective adjunct to psychosocial treatment for cocaine dependence would constitute a major public health advancement.”

Pathological Gambling

Researchers from the University of Minnesota School of Medicine enrolled 27 participants with pathological addiction to gambling in a study to examine the effectiveness of NAC. Significant reductions of gambling behaviors were observed in 16 participants, according to the study, which appears in the journal Biological Psychiatry.

Hair Pulling

Researchers from the University of Minnesota School of Medicine conducted a 12-week, double-blind controlled trial among 50 individuals with compulsive hair-pulling, a condition known as trichotillomania.

The results appear in the Archives of General Psychiatry, a publication of the American Medical Association. “Fifty-six percent of patients ‘much or very much improved’ with N-acetylcysteine use compared with 16 percent taking placebo,” the authors write. “Significant improvement was initially noted after nine weeks of treatment.”

More: Hair Pulling Halted by Amino Acid

So what can these studies on NAC teach us? Science is discovering, perhaps anew, the ways in which nutrition’s role is not confined to the physical body, but extends above the neck and into our brain and mind. A body of research now shows the promise of the use of the supplement NAC for smoking, marijuana dependence, cocaine dependence, pathological gambling and hair pulling.

Let’s hope that further studies support these and reveal more about how nutrition can help improve brain function, control addictive and compulsive behaviors and improve our wellbeing and mental health.

Now I’d like to hear from you:

Do you have problems with self-control? Do you suffer from compulsions, addictions or impulsive behaviors?

Did you get any treatment for that?

Have you found anything that gives you more control?

Please let me know your thoughts by posting a comment below.

Best Health,

Jonathan Galland

References and Further Reading

Am Fam Physician. 2009 Aug 1;80(3):265-9., N-acetylcysteine: multiple clinical applications., Millea PJ. Mid-Atlantic Permanente Medical Group, P.C., Falls Church, VA 22046, USA.

Toxicol Sci. 2011 Mar;120(1):87-97. Epub 2010 Dec 6. “The cytoprotective effect of N-acetyl-L-cysteine against ROS-induced cytotoxicity is independent of its ability to enhance glutathione synthesis.” Zhang F, Lau SS, Monks TJ. Department of Pharmacology and Toxicology, College of Pharmacy, University of Arizona Health Science Center, Tucson, Arizona 85721, USA.

Innov Clin Neurosci. 2011 Jan;8(1):10-4. “Getting a Knack for NAC: N-Acetyl-Cysteine.” Sansone RA, Sansone LA. Dr. R. Sansone is a professor in the Departments of Psychiatry and Internal Medicine at Wright State University School of Medicine in Dayton, Ohio.

J Psychiatry Neurosci. 2011 March; 36(2): 78–86. doi: 10.1503/jpn.100057 “N-acetylcysteine in psychiatry: current therapeutic evidence and potential mechanisms of action” Olivia Dean, BSc, PhD, Frank Giorlando, MBBS, BMedSc, and Michael Berk, MBBCh, MMed(Psych), PhD, Dean, Berk — Mental Health Research Institute, Parkville; Dean, Giorlando, Berk — Department of Clinical and Biomedical Sciences, Barwon Health, University of Melbourne, Geelong; Berk — Youth Health Orygen Research Centre, Parkville, and the School of Medicine, Faculty of Health, Medicine, Nursing and Behavioural Sciences, Deakin University, Geelong, Victoria, Australia

Biol Psychiatry. 2009 May 15;65(10):841-5. Epub 2008 Dec 21. “The role of cystine-glutamate exchange in nicotine dependence in rats and humans.” Knackstedt LA, LaRowe S, Mardikian P, Malcolm R, Upadhyaya H, Hedden S, Markou A, Kalivas PW. Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina 29425, USA.

Am J Addict. 2010 Mar-Apr;19(2):187-9. “N-acetylcysteine (NAC) in young marijuana users: an open-label pilot study.” Gray KM, Watson NL, Carpenter MJ, Larowe SD.

Prog Neuropsychopharmacol Biol Psychiatry. 2007 Mar 30;31(2):389-94. Epub 2006 Nov 17. “An open-label trial of N-acetylcysteine for the treatment of cocaine dependence: a pilot study.”Mardikian PN, LaRowe SD, Hedden S, Kalivas PW, Malcolm RJ. Center for Drug and Alcohol Programs, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, SC 29425, USA.

Am J Addict. 2006 Jan-Feb;15(1):105-10. “Safety and tolerability of N-acetylcysteine in cocaine-dependent individuals.” LaRowe SD, Mardikian P, Malcolm R, Myrick H, Kalivas P, McFarland K, Saladin M, McRae A, Brady K. Center for Drug and Alcohol Programs, Medical University of South Carolina, Charleston, South Carolina 29425, USA.

Am J Psychiatry 2007;164:1115-1117. 10.1176/appi.ajp.164.7.1115, “Is Cocaine Desire Reduced by N-Acetylcysteine?” Steven D. LaRowe; Hugh Myrick; Sarra Hedden; Pascale Mardikian; Michael Saladin; Aimee McRae; Kathleen Brady; Peter W. Kalivas; Robert Malcolm

Biol Psychiatry. 2007 Sep 15;62(6):652-7. Epub 2007 Apr 18. “N-acetyl cysteine, a glutamate-modulating agent, in the treatment of pathological gambling: a pilot study.” Grant JE, Kim SW, Odlaug BL. Department of Psychiatry, University of Minnesota School of Medicine, 2450 Riverside Avenue, Minneapolis, MN 55454, USA.

Archives of General Psychiatry, 2009;66(7):756-763. “N-Acetylcysteine, a Glutamate Modulator, in the Treatment of Trichotillomania: A Double-blind, Placebo-Controlled Study” Jon E. Grant, JD, MD, MPH; Brian L. Odlaug, BA; Suck Won Kim, MD, Department of Psychiatry, University of Minnesota School of Medicine, Minneapolis.Respir J. 1997 Jul;10(7):1535-41 Attenuation of influenza-like symptomatology and improvement of cell-mediated immunity with long-term N-acetylcysteine treatment. De Flora S, Grassi C, Carati L.