Could N-acetylcysteine improve the safety of clozapine?
N-acetylcysteine
clozapine
safety
schizophrenia
Journal
Human psychopharmacology
ISSN: 1099-1077
Titre abrégé: Hum Psychopharmacol
Pays: England
ID NLM: 8702539
Informations de publication
Date de publication:
03 2021
03 2021
Historique:
revised:
04
11
2020
received:
30
07
2020
accepted:
05
11
2020
pubmed:
19
11
2020
medline:
27
1
2022
entrez:
18
11
2020
Statut:
ppublish
Résumé
Clozapine is an atypical antipsychotic indicated in patients with treatment-resistant schizophrenia which remains underused due to safety issues. Mechanisms behind these adverse effects are complex and not fully understood. They may involve immune-related mechanisms, direct toxic effects and oxidative stress. Clozapine-induced oxidative stress might indeed notably be involved in the onset of neutropenia, agranulocytosis, myocarditis, sialorrhea, and metabolic alterations. Therefore, the association of N-acetylcysteine (NAC), an easily accessible, low-cost and well tolerated antioxidant drug could be of interest in clozapine-treated patients to improve clozapine safety. Furthermore, according to recent studies NAC could help to improve schizophrenia symptoms. We believe that the use of NAC in the context of clozapine prescribing merits further study, as it could improve clozapine safety which may lead to a wider use and ultimately improve the healthcare of thousands of patients. NAC could also secondarily show positive knock-on effects for the patients by improving clinical symptoms of schizophrenia in synergy with clozapine, and by reducing substance abuse and thus by improving the patient's overall condition. However, given the rarity of clozapine-induced severe adverse effects, only a large volume of data (e.g., National adverse events monitoring) could assess the benefits of NAC on clozapine safety.
Substances chimiques
Antipsychotic Agents
0
Clozapine
J60AR2IKIC
Acetylcysteine
WYQ7N0BPYC
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e2769Informations de copyright
© 2020 John Wiley & Sons Ltd.
Références
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