Date of Award
Selective Evidence-Based Medicine Review
Master of Science in Health Sciences - Physician Assistant
Physician Assistant Studies
Laura Levy, DHSc, PA-C
OBJECTIVE: The objective of this selective EBM review is to determine whether or not “In adult patients with Obsessive Compulsive Disorder (OCD), is the amino acid N-Acetyl Cysteine (NAC) effective in reducing severity of OCD?”
STUDY DESIGN: Review of three English language primary studies, published between 2015-2017.
DATA SOURCES: Three randomized controlled trials (RCTs) were found using PubMed-NCBI. These studies analyzed the effectiveness in reducing the severity of OCD in adults with OCD. OUTCOME MEASURED: The main outcome measured was a reduction of OCD severity after taking N-Acetyl Cysteine. Outcomes were measured using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Participants answered a 67 part questionnaire about their everyday habits. From the questionnaire, the interviewer generated a list of target OCD symptoms. The target symptoms were then used in 19 interview style questions asking about the severity of each symptom. The severity of those symptoms range from 0-4, with 4 being the highest severity. Questions 1-10 were added together for a Y-BOCS final score, based on the patient’s responses.
RESULTS: There was an overall reduction of symptoms from the beginning to end of each trial. However, the placebo group had a similar reduction in symptoms, which made the results statistically insignificant. In the study conducted by Costa et al. 6 of 16 patients in the NAC group versus 5 of 19 patients in the control group had a significant reduction in Y-BOCS score (P=0.40). In the results of the study by Paydray et al. 11 of 22 in the NAC group and 8 of 22 in the control group had a significant reduction in Y-BOCS score (P=0.54). In the study conducted by Sarris et al. 4 of 20 patients in the NAC group versus 4 of 15 in the control group had a significant reduction in Y-BOCS score (P=0.15).
CONCLUSION: The results of the RCTs remain inconclusive as to whether NAC is an effective medication for reducing the severity of OCD in adults. NAC as an alternative treatment to current medications for OCD remains affordable and tolerable, indicating further research is needed for its efficacy.
Toles, Sabrina M., "In Adult Patients with Obsessive Compulsive Disorder (OCD), is the Amino Acid N-Acetyl Cysteine (NAC) Effective in Reducing Severity of OCD?" (2019). PCOM Physician Assistant Studies Student Scholarship. 438.