Overview

Evaluating the Hypothesized Mechanism of Action of N-acetylcysteine for Bipolar Disorder

Status:
Not yet recruiting
Trial end date:
2023-01-21
Target enrollment:
0
Participant gender:
All
Summary
This research study evaluates the effects of anFDA-approved medication NAC in individuals with Bipolar Disorder. Participants in the study will will be assigned to two medication conditions and will take both NAC and a matched placebo. The order in which they take each medication will be random. Study medication will be taken for 14 days. There will be 5 study visits, with 2 MRI brain imaging scans completed. Questionnaires and clinical interview measures will be completed at study visits along with consistent assessment of potential side effects from study medication.
Phase:
Phase 2
Accepts Healthy Volunteers?
No
Details
Lead Sponsor:
Medical University of South Carolina
Collaborator:
Milken Institute Center for Strategic Philanthropy
Treatments:
Acetylcysteine
N-monoacetylcystine
Criteria
Inclusion Criteria:

1. Ages 18-60 years

2. Meet DSM-5 criteria for bipolar I or II disorder

3. Able to provide informed consent and read, understand, and accurately complete
assessment instruments

4. Willing to commit to medication treatment and follow-up assessments

5. Meets DSM-5 criteria for any mood episode (i.e., Major Depressive, Hypomanic, Manic),
Current or In Partial Remission

6. Prescribed daily use of at least one FDA-approved mood stabilizing medication (i.e.,
lithium, divalproex sodium, lamotrigine, 2nd generation antipsychotic)

7. Willing to abstain from antioxidant supplements (e.g., coenzyme Q-10, vitamin E) for
the duration of the study.

Exclusion Criteria:

1. A primary psychiatric diagnosis other than BD (e.g., Schizophrenia)

2. Meet DSM-5 criteria for substance use disorder (other than Tobacco Use Disorder)
within the past 6 months.

3. Any uncontrolled neurological condition (e.g., epilepsy) that could confound the
results of the study

4. Any history of brain injury with loss of consciousness greater than 5 minutes

5. Any history of mental retardation, dementia, or recent electroconvulsive therapy (in
the past 3 months)

6. Any uncontrolled medical condition that may adversely affect the conduct of the study
or jeopardize the safety of the participant

7. Hepatocellular disease as indicated by plasma levels of liver transaminases (aspartate
transaminase, alanine transaminase) greater than 3 times the normal range

8. Renal insufficiency as indicated by plasma levels of creatinine greater than 2 times
the normal range

9. Concomitant use of nitroglycerine, carbamazepine, or any other medication deemed to be
hazardous if taken with N-Acetylcysteine (NAC).

10. Medication dose changes of ≥ 20% ≤ 2 weeks prior to testing

11. Women of childbearing potential who are pregnant, lactating, or refuse adequate forms
of contraception

12. Current suicidal or homicidal risk

13. Baseline scores greater than 35 on the Montgomery-Asberg Depression Rating Scale or
greater than 25 on the Young Mania Rating Scale

14. Has taken NAC in the last month or experienced adverse effects/allergic reaction from
it at any time

15. Significant claustrophobia and/or past negative experiences with MRI

16. Presence of non-MRI safe materials in the body (e.g., ferrous metal implants,
pacemaker)