Page 86 - ITPS-8-1

INNOSC Theranostics

and Pharmacological Sciences

ORIGINAL RESEARCH ARTICLE
Brain glutamate level after treatment with

N-acetylcysteine in obsessive-compulsive
disorder patients: A randomized trial

Sadia Binte Anwar Sonia 1 , Md Sayedur Rahman , Mahbuba Shirin ,
2
3
Muhammad Nurul Alam Siddiki 4 , Sarmin Sultana 5 ,
Iftekhar Hossain Chowdhury * , Humayra Rumu 7 , and Nazla Shamsuddoha 8
6
1 Department of Pharmacology, Armed Forces Medical College, Dhaka, Bangladesh
2 Department of Pharmacology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
3 Department of Radiology and Imaging, Bangabandhu Sheikh Mujib Medical University, Dhaka,
Bangladesh
4 Department of Ophthalmology, Combined Military Hospital, Dhaka, Bangladesh
5 Department of Pharmacology, Army Medical College, Jashore, Bangladesh
6 Department of Pharmacology, Mugda Medical College and Hospital, Dhaka, Bangladesh
7 Department of Dental Pharmacology, Shaheed Suhrawardy Medical College, Dhaka, Bangladesh
8 Department of Pharmacology, Medical College for Women and Hospital, Dhaka, Bangladesh

*Corresponding author:
Iftekhar Hossain Chowdhury
(chowdhuryiftekhar60@gmail.com) Abstract
Citation: Sonia SBA, Rahman MS,
Shirin M, et al. Brain glutamate Selective serotonin reuptake inhibitors (SSRIs) are routinely used to treat patients
level after treatment with with obsessive–compulsive disorder (OCD); however, 40 – 60% of patients with
N-acetylcysteine in obsessive- OCD do not respond to SSRIs. Glutamate dysfunction may play a key role in OCD
compulsive disorder patients:
A randomized trial. INNOSC pathogenesis. N-acetylcysteine (NAC), a glutamate-modulating drug, targets the
Theranostics and Pharmacological glutamatergic system. This study aimed to assess whether the addition of NAC
Sciences. 2025;8(1):80-90. reduces the severity of OCD symptoms in patients with SSRI-treated moderate-
doi: 10.36922/itps.4887
to-severe OCD. A total of 60 patients with OCD were diagnosed according to the
Received: September 19, 2024 DSM-5 criteria, and severity of the symptoms was assessed using the Yale–Brown
Revised: December 5, 2024 obsessive–compulsive scale (Y-BOCS). Patients were administered 2,400 mg/day of
SSRIs plus placebo (placebo arm) or 2,400 mg/day (NAC arm) of SSRIs plus NAC for
Accepted: December 18, 2024
10 weeks. Serum alanine aminotransferase, aspartate aminotransferase, creatinine,
Published online: January 17, and electrocardiogram were monitored to evaluate the safety of NAC. The Y-BOCS
2025 score was not significantly different between the two arms at baseline; however, it
Copyright: © 2025 Author(s). was significantly different between the two arms after 4 (P = 0.03) and 10 (P = 0.00)
This is an Open-Access article weeks. The NAC arm had a reduction of 8.4 (25.51 – 17.15) points compared with
distributed under the terms of the
Creative Commons Attribution 1.42 (25.07 – 23.65) points for the placebo arm from baseline to 10 weeks. NAC
License, permitting distribution, was well-tolerated and caused mild gastrointestinal adverse events. Thus, NAC is
and reproduction in any medium, an effective glutamate-modulating drug as and can be used as an augmentation
provided the original work is
properly cited. therapy with standard treatment in patients with moderate-to-severe OCD.
Publisher’s Note: AccScience
Publishing remains neutral with Keywords: Glutamate; N-acetylcysteine; Obsessive–compulsive disorder; Yale–Brown
regard to jurisdictional claims in
published maps and institutional obsessive–compulsive scale
affiliations.

Volume 8 Issue 1 (2025) 80 doi: 10.36922/itps.4887