{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T02:56:26Z","timestamp":1791860186914,"version":"4.3.4"},"reference-count":60,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,2,18]],"date-time":"2018-02-18T00:00:00Z","timestamp":1518912000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004733","name":"Universidade de Macau","doi-asserted-by":"publisher","award":["MYRG2015\u201000230\u2010FHS;"],"award-info":[{"award-number":["MYRG2015\u201000230\u2010FHS;"]}],"id":[{"id":"10.13039\/501100004733","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004733","name":"Universidade de Macau","doi-asserted-by":"publisher","award":["MYRG2016\u201000"],"award-info":[{"award-number":["MYRG2016\u201000"]}],"id":[{"id":"10.13039\/501100004733","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009659","name":"Guangzhou Medical University","doi-asserted-by":"publisher","award":["22016YFC0906302"],"award-info":[{"award-number":["22016YFC0906302"]}],"id":[{"id":"10.13039\/100009659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009659","name":"Guangzhou Medical University","doi-asserted-by":"publisher","award":["2014Y2\u201000105"],"award-info":[{"award-number":["2014Y2\u201000105"]}],"id":[{"id":"10.13039\/100009659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009659","name":"Guangzhou Medical University","doi-asserted-by":"publisher","award":["2015BAI13B02"],"award-info":[{"award-number":["2015BAI13B02"]}],"id":[{"id":"10.13039\/100009659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["1059660"],"award-info":[{"award-number":["1059660"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Psychiatr Scand"],"published-print":{"date-parts":[[2018,5]]},"abstract":"\n Objective<\/jats:title>\n \n This systematic review and meta\u2010analysis of randomized controlled trials (\n RCT<\/jats:styled-content>\n s) examined the efficacy and safety of adjunctive\n N<\/jats:italic>\n \u2010acetylcysteine (\n NAC<\/jats:styled-content>\n ), an antioxidant drug, in treating major depressive disorder (\n MDD<\/jats:styled-content>\n ), bipolar disorder, and schizophrenia.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n The PubMed, Cochrane Library, Psyc\n INFO<\/jats:styled-content>\n ,\n CNKI<\/jats:styled-content>\n ,\n CBM<\/jats:styled-content>\n , and WanFang databases were independently searched and screened by two researchers. Standardized mean differences (\n SMD<\/jats:styled-content>\n s), risk ratios, and their 95% confidence intervals (\n CI<\/jats:styled-content>\n s) were computed.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Six\n RCT<\/jats:styled-content>\n s (\n n<\/jats:italic>\n = 701) of\n NAC<\/jats:styled-content>\n for schizophrenia (three\n RCT<\/jats:styled-content>\n s,\n n<\/jats:italic>\n = 307), bipolar disorder (two\n RCT<\/jats:styled-content>\n s,\n n<\/jats:italic>\n = 125), and\n MDD<\/jats:styled-content>\n (one\n RCT<\/jats:styled-content>\n ,\n n<\/jats:italic>\n = 269) were identified and analyzed as separate groups. Adjunctive\n NAC<\/jats:styled-content>\n significantly improved total psychopathology (\n SMD<\/jats:styled-content>\n = \u22120.74, 95%\n CI<\/jats:styled-content>\n : \u22121.43, \u22120.06;\n I<\/jats:italic>\n 2<\/jats:sup>\n = 84%,\n P<\/jats:italic>\n = 0.03) in schizophrenia, but it had no significant effect on depressive and manic symptoms as assessed by the Young Mania Rating Scale in bipolar disorder and only a small effect on major depressive symptoms. Adverse drug reactions to\n NAC<\/jats:styled-content>\n and discontinuation rates between the\n NAC<\/jats:styled-content>\n and control groups were similar across the three disorders.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Adjunctive\n NAC<\/jats:styled-content>\n appears to be a safe treatment that has efficacy for schizophrenia, but not for bipolar disorder or\n MDD<\/jats:styled-content>\n . Further higher quality\n RCT<\/jats:styled-content>\n s are warranted to determine the role of adjunctive\n NAC<\/jats:styled-content>\n in the treatment of major psychiatric disorders.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/acps.12862","type":"journal-article","created":{"date-parts":[[2018,2,18]],"date-time":"2018-02-18T22:54:28Z","timestamp":1518994468000},"page":"391-400","source":"Crossref","is-referenced-by-count":81,"title":["N<\/i>\n \u2010acetylcysteine for major mental disorders: a systematic review and meta\u2010analysis of randomized controlled trials"],"prefix":"10.1111","volume":"137","author":[{"given":"W.","family":"Zheng","sequence":"first","affiliation":[{"name":"The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital) Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Q.\u2010E.","family":"Zhang","sequence":"additional","affiliation":[{"name":"The National Clinical Research Center for Mental Disorders Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital Capital Medical University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.\u2010B.","family":"Cai","sequence":"additional","affiliation":[{"name":"Clinics of Chinese Medicine the First Clinical Medical College of Guangzhou University of Chinese Medicine Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"X.\u2010H.","family":"Yang","sequence":"additional","affiliation":[{"name":"The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital) Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.","family":"Qiu","sequence":"additional","affiliation":[{"name":"The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital) Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. S.","family":"Ungvari","sequence":"additional","affiliation":[{"name":"The University of Notre Dame Australia\/Graylands Hospital Perth WA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. H.","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Melbourne Melbourne Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Berk","sequence":"additional","affiliation":[{"name":"School of Medicine IMPACT Strategic Research Centre Barwon Health Deakin University Geelong Vic. Australia"},{"name":"Orygen The Centre of Excellence in Youth Mental Health Department of Psychiatry and the Florey Institute of Neuroscience and Mental Health The University of Melbourne Melbourne Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.\u2010P.","family":"Ning","sequence":"additional","affiliation":[{"name":"The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital) Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2906-0029","authenticated-orcid":false,"given":"Y.\u2010T.","family":"Xiang","sequence":"additional","affiliation":[{"name":"Unit of Psychiatry Faculty of Health Sciences University of Macau Macao SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,2,18]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)61611-6"},{"key":"e_1_2_9_3_1","unstructured":"MathersC BoermaJT FatDM World Health Organization.The global burden of disease: 2004 update. Published by the Harvard School of Public Health on behalf of the World Health Organization and the World Bank 2008."},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20128"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12991-017-0133-7"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20420"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.3371\/CSRP.5.4.5"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.plefa.2017.05.004"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2013.03.018"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.13099"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1819.2009.02004.x"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-017-2277-4"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2005.10.011"},{"key":"e_1_2_9_14_1","first-page":"326","article-title":"Effects of lithium and valproate on amphetamine\u2010induced oxidative stress generation in an animal model of mania","volume":"31","author":"Frey BN","year":"2006","journal-title":"J Psychiatry Neurosci"},{"key":"e_1_2_9_15_1","unstructured":"ShaoL YoungLT WangJ.The effect of the mood stabilizer valproate on the major brain antioxidant glutathione and functionally related enzymes in human neuroblastoma SH\u2010SY5Y cells in Convention of the Society\u2010Of\u2010Biological\u2010Psychiatry 2005 pp.19S."},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2017.04.004"},{"issue":"2","key":"e_1_2_9_17_1","first-page":"CD008919","article-title":"Antioxidant treatments for schizophrenia","author":"Magalhaes PV","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1515\/BC.2003.059"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tips.2013.01.001"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1503\/jpn.100057"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.2165\/00003088-199120020-00004"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcb.22196"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1038\/npp.2011.109"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1165\/rcmb.2007-0447OC"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.onc.1210796"},{"key":"e_1_2_9_26_1","first-page":"237","article-title":"Oxidative stress in schizophrenia \u2013 focusing on the main markers","volume":"23","author":"Ciobica A","year":"2011","journal-title":"Psychiatr Danub"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4939-0440-2_3"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2012.05.022"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2008.03.004"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2008.04.022"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.13m08454"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/WNF.0000000000000001"},{"key":"e_1_2_9_33_1","first-page":"515","article-title":"N\u2010acetylcysteine add on treatment for depressive symptoms in bipolar disorder: a comparative trial (in Chinese)","volume":"10","author":"Hu CC","year":"2012","journal-title":"Clin Educ Gen Pract"},{"key":"e_1_2_9_34_1","first-page":"394","article-title":"Treatment effect of risperidone alone and combined with N\u2010acetyl\u2010cysteine for first\u2010episode schizophrenic patients (in Chinese)","volume":"25","author":"Zhang JH","year":"2015","journal-title":"J Clin Psychiatry"},{"key":"e_1_2_9_35_1","first-page":"190","article-title":"Placebo\u2010controlled augmentation trials of the antioxidant NAC in schizophrenia: a review","volume":"28","author":"Chen AT","year":"2016","journal-title":"Ann Clin Psychiatry"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.15r09984"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/9780470712184"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-151-4-200908180-00135"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/0197-2456(86)90046-2"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1186"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/0197-2456(95)00134-4"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2010.07.015"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.328.7454.1490"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/13.2.261"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7109.629"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.1080\/15622970903144004"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1097\/JCP.0b013e31829839c6"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2011.06.005"},{"key":"e_1_2_9_49_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-5618.2009.00717.x"},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pnpbp.2008.07.001"},{"key":"e_1_2_9_51_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0138904"},{"key":"e_1_2_9_52_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.61.3.300"},{"key":"e_1_2_9_53_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.11r07237"},{"key":"e_1_2_9_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejphar.2012.06.014"},{"key":"e_1_2_9_55_1","doi-asserted-by":"publisher","DOI":"10.1038\/mp.2016.3"},{"key":"e_1_2_9_56_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00011-011-0323-8"},{"key":"e_1_2_9_57_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI29444"},{"key":"e_1_2_9_58_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajad.12620"},{"key":"e_1_2_9_59_1","doi-asserted-by":"publisher","DOI":"10.9758\/cpn.2015.13.1.12"},{"key":"e_1_2_9_60_1","doi-asserted-by":"publisher","DOI":"10.1179\/1351000215Y.0000000004"},{"key":"e_1_2_9_61_1","doi-asserted-by":"publisher","DOI":"10.1001\/archgenpsychiatry.2009.60"}],"container-title":["Acta Psychiatrica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Facps.12862","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/acps.12862","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T08:06:37Z","timestamp":1695542797000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/acps.12862"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,2,18]]},"references-count":60,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2018,5]]}},"alternative-id":["10.1111\/acps.12862"],"URL":"https:\/\/doi.org\/10.1111\/acps.12862","archive":["Portico"],"relation":{},"ISSN":["0001-690X","1600-0447"],"issn-type":[{"value":"0001-690X","type":"print"},{"value":"1600-0447","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,2,18]]}}}