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Interleukin-6 and total antioxidant capacity levels following N-acetylcysteine and a combination nutraceutical intervention in a randomised controlled trial for bipolar disorder

Published online by Cambridge University Press:  30 June 2020

C.C. Bortolasci Open the ORCID record for C.C. Bortolasci [Opens in a new window] ,
C. Voigt ,
A. Turner ,
M. Mohebbi ,
L. Gray ,
S. Dodd ,
K. Walder ,
M. Berk ,
S.M. Cotton  and
G.S. Malhi Open the ORCID record for G.S. Malhi [Opens in a new window]
...Show all authors
C.C. Bortolasci
Affiliation:
The Institute for Mental and Physical Health and Clinical Translation, Deakin University, Barwon Health, Geelong, Australia
C. Voigt
Affiliation:
University of Bremen, Bremen, Germany
A. Turner
Affiliation:
The Institute for Mental and Physical Health and Clinical Translation, Deakin University, Barwon Health, Geelong, Australia
M. Mohebbi
Affiliation:
Biostatistics Unit, Faculty of Health, Deakin University, Geelong, Australia
L. Gray
Affiliation:
The Institute for Mental and Physical Health and Clinical Translation, Deakin University, Barwon Health, Geelong, Australia
S. Dodd
Affiliation:
The Institute for Mental and Physical Health and Clinical Translation, Deakin University, Barwon Health, Geelong, Australia Department of Psychiatry, The University of Melbourne, Parkville, Australia Orygen, Parkville, Australia
K. Walder
Affiliation:
The Institute for Mental and Physical Health and Clinical Translation, Deakin University, Barwon Health, Geelong, Australia
M. Berk
Affiliation:
The Institute for Mental and Physical Health and Clinical Translation, Deakin University, Barwon Health, Geelong, Australia Department of Psychiatry, The University of Melbourne, Parkville, Australia Orygen, Parkville, Australia The Florey Institute of Neuroscience and Mental Health, Parkville, Australia Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
S.M. Cotton
Affiliation:
Orygen, Parkville, Australia Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
G.S. Malhi
Affiliation:
Northern Clinical School, Department of Psychiatry, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia Academic Department of Psychiatry, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, Australia CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, Australia
C.H. Ng
Affiliation:
Professorial Unit, The Melbourne Clinic, Department of Psychiatry, The University of Melbourne, Melbourne, Australia
N. Dowling
Affiliation:
Professorial Unit, The Melbourne Clinic, Department of Psychiatry, The University of Melbourne, Melbourne, Australia
J. Sarris
Affiliation:
Professorial Unit, The Melbourne Clinic, Department of Psychiatry, The University of Melbourne, Melbourne, Australia NICM Health Research Institute, Western Sydney University, Westmead, Australia
O.M. Dean*
Affiliation:
The Institute for Mental and Physical Health and Clinical Translation, Deakin University, Barwon Health, Geelong, Australia Department of Psychiatry, The University of Melbourne, Parkville, Australia The Florey Institute of Neuroscience and Mental Health, Parkville, Australia
*
Author for correspondence: O.M. Dean, Email: [email protected]
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Abstract

Objective:

The aims of this study were to evaluate changes in inflammatory and oxidative stress levels following treatment with N-acetylcysteine (NAC) or mitochondrial-enhancing agents (CT), and to assess the how these changes may predict and/or moderate clinical outcomes primarily the Montgomery-Åsberg Depression Rating Scale (MADRS).

Methods:

This study involved secondary analysis of a placebo-controlled randomised trial (n = 163). Serum samples were collected at baseline and week 16 of the clinical trial to determine changes in Interleukin-6 (IL-6) and total antioxidant capacity (TAC) following adjunctive CT and/or NAC treatment, and to explore the predictability of the outcome or moderator effects of these markers.

Results:

In the NAC-treated group, no difference was observed in serum IL-6 and TAC levels after 16 weeks of treatment with NAC or CT. However, results from a moderator analysis showed that in the CT group, lower IL-6 levels at baseline was a significant moderator of MADRS χ2 (df) = 4.90, p = 0.027) and Clinical Global Impression-Improvement (CGI-I, χ2 (df) = 6.28 p = 0.012). In addition, IL-6 was a non-specific but significant predictor of functioning (based on the Social and Occupational Functioning Assessment Scale (SOFAS)), indicating that individuals with higher IL-6 levels at baseline had a greater improvement on SOFAS regardless of their treatment (p = 0.023).

Conclusion:

Participants with lower IL-6 levels at baseline had a better response to the adjunctive treatment with the mitochondrial-enhancing agents in terms of improvements in MADRS and CGI-I outcomes.

Keywords

bipolar disorderN-acetylcysteineclinical trialantioxidantinflammation
Type
Original Article
Information
Acta Neuropsychiatrica , Volume 32 , Issue 6 , December 2020 , pp. 313 - 320
Copyright
© Scandinavian College of Neuropsychopharmacology 2020

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