N-acetylcysteine (NAC) for methamphetamine dependence: A randomised controlled trial

What this study found

NAC did not improve methamphetamine use outcomes versus placebo over 12 weeks. Methamphetamine use days fell in both groups, but the between-group difference was not significant (0.5 days, 97.5% CI -3.4 to 4.3), and mean reduction in use days was similar: placebo 7.3 [1.2] versus NAC 6.8 [1.2]. NAC also showed no significant benefit for methamphetamine-positive oral fluid samples, craving, severity of dependence, withdrawal, hostility, depression, or suicidality. Adverse events were similar overall, with 11 serious adverse events affecting 10 participants (6 on NAC, 4 on placebo).

Study & population

Randomized, placebo-controlled trial in adults with methamphetamine dependence who were seeking to reduce use.

Intervention

Participants in the active arm received oral N-acetylcysteine (NAC) 2400 mg/day for 12 weeks, given as two 600 mg capsules twice daily in the morning and evening.

Key limitation

The trial tested a single NAC dose for a relatively short 12-week period, which limits inference about longer-term treatment effects.

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