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INNOSC Theranostics and
Pharmacological Sciences Brain glutamate level after treatment with NAC

significant adverse effects were recorded, and the rates Conflict of interest
of various adverse effects were not different between the
NAC and placebo arms. Compared with previous studies The authors declared that they have no competing interests.
examining the effectiveness of NAC in OCD, this study had Author contributions
a larger sample size, double-blind, randomized, placebo-
controlled design, and clearly specified inclusion/exclusion Conceptualization: Sadia Binte Anwar Sonia
criteria. Formal analysis: Muhammad Nurul Alam Siddiki, Iftekhar
Hossain Chowdhury, Sarmin Sultana
5. Limitations Investigation: Mahbuba Shirin
Methodology: Sadia Binte Anwar Sonia, Md Sayedur
NAC was administered at the highest dosage starting in week Rahman
3. Thus, to effectively treat OCD symptoms, long durations Writing – original draft: Sadia Binte Anwar Sonia
or high dosages are needed. A small sample was analyzed; Writing – review & editing: Humayra Rumu, Nazla
thus, results with a larger sample size might be trustworthy Shamsuddoha
and accurate. Furthermore, whether the effects of NAC are
durable or if the symptoms would recur if NAC was stopped is Ethics approval and consent to participate
unclear. Finally, the use of magnetic resonance spectroscopy,
a neuroimaging approach, to evaluate glutamate activity and The Helsinki Declaration and subsequent changes were
other important biomarkers or pharmacodynamic pathways followed in conducting the study. The research protocol
in the brain would have been adequate. was approved by the institutional review board (IRB)
of Bangabandhu Sheikh Mujib Medical University,
Considerably, this study does not support the suggestion Dhaka, BD, on March 15, 2021 (approval number
that NAC should be used regularly as an adjuvant drug to BSMMU/2021/2300). This clinical trial was registered on
treat adult OCD symptoms. Therefore, the effect of NAC ClinicalTrials.gov with the trial ID number NCT04904952.
on OCD must be examined. Future studies should examine Every patient provided written, informed consent, and
how NAC works in conjunction with other drugs to treat every patient was informed about the intervention and
OCD. the study objectives. They were also informed that there
6. Conclusion was the least possible chance of any harm to the patient by
inclusion in this study, and if any complication arose due
NAC is safe and effective to be used as augmentation to the intervention, they were offered free treatment for
therapy with standard treatment (SSRIs) in adult patients that complication. Patients were informed that they could
with moderate-to-severe OCD, results in earlier and participate in this study of their own free will and that they
greater reduction of OCD symptoms, and reduces the were free to refuse to participate or to withdraw at any
burden of this distressing illness. time without compromising their medical care. Patients
who took part in the study willingly with written consent
Acknowledgments were interviewed. Patient’s confidentiality was strictly
The authors gratefully appreciate the contribution of Prof. maintained. Patient’s personal data regarding name, age,
M. M. A. Shalahuddin Qusar, Department of Psychiatry, sex, and other information were not disclosed anywhere
BSMMU, Brig. Gen. M Kumrul Hasan, Adviser Specialist and were used for research purposes only.
in the Department of Psychiatry, CMH, Dhaka. The authors
would like to express my gratitude to Prof. Ahmed Abu Saleh, Consent for publication
Department of Microbiology, BSMMU, for his kind-hearted Not applicable.
support regarding randomization and blinding procedures
of this research. The authors also grateful to Dr. Monirul Availability of data
Islam, Research Assistant of the Department of Psychiatry, The data that support the findings of this study are not
BSMMU, for his valuable advice and help during the study publicly available due to the presence of information that
period and permitting me to use the validated Bangla version could compromise the privacy of research participants but
of Y-BOCS in this research. I would like to give thanks to all are available from the corresponding author.
the officers of CMH, Dhaka, for their valuable advice and
cooperation throughout my study period. References

Funding 1. American Psychiatric Association (APA). What is Obsessive-
Compulsive Disorder? American Psychiatric Association;
None. 2013. Available from: https://www.psychiatry.org/patients-

Volume 8 Issue 1 (2025) 86 doi: 10.36922/itps.4887