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Nail-Biting Stuff? The Effect of N-acetyl Cysteine on Nail-Biting

Published online by Cambridge University Press:  07 November 2014

Michael Berk ,
Sue Jeavons ,
Olivia M. Dean ,
Seetal Dodd ,
Kirsteen Moss ,
Clarissa S. Gama  and
Gin S. Malhi
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Abstract

N-acetyl cysteine (NAC) is a widely available nutraceutical with a variety of actions. As a precursor of cysteine and glutathione, it has antioxidant properties that may impact on mood and contribute to an effect on impulsivity and obsessive behaviour. Via its additional effect on glutamate via the cystine-glutamate exchange system, NAC has been shown to mediate impulsivity in preclinical models of addiction, reduce craving, and cue extinction. Further, by boosting glutathione, NAC acts as a potent antioxidant and has been shown in two positive, large-scale randomized placebo-controlled trials to affect negative symptoms in schizophrenia and depression in bipolar disorder. We describe three cases in which its actions specifically on nail-biting and associated anxiety may offer a potential treatment. The spontaneous findings are reported as part of an ongoing treatment trial examining the utility of NAC in bipolar disorder. Its actions, if robustly replicated, also point to potential treatment targets in glutathione or glutamate pathways in the brain.

Type
Case Report
Information
CNS Spectrums , Volume 14 , Issue 7 , July 2009 , pp. 357 - 360
Copyright
Copyright © Cambridge University Press 2009

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References

REFERENCES

1.Bohne, A, Keuthen, N, Wilhelm, S. Pathologic hair pulling, skin picking, and nail biting. Ann Clin Psychiatry. 2005;17:227–232.Google Scholar
2.Leonard, HL, Lenane, MC, Swedo, SE, Rettew, DC, Rapoport, JL. A double-blind comparison of clomipramine and desipramine treatment of severe onychophagia (nail biting). Arch Gen Psychiatry. 1991;48:821–827.Google Scholar
3.Dodd, S, Dean, O, Copolov, DL, Malhi, GS, Berk, M. N-acetylcysteine for antioxidant therapy: pharmacology and clinical utility. Expert Opin Biol Ther. 2008;8:1955–1962.Google Scholar
4.Aitio, ML. N-acetylcysteine--passe-partout or much ado about nothing? Br J Clin Pharmacol. 2006;61:5–15.Google Scholar
5.Odlaug, BL, Grant, JE. N-acetyl cysteine in the treatment of grooming disorders. J Clin Psychopharmacol. 2007;27:227–229.Google Scholar
6.Lafleur, DL, Pittenger, C, Kelmendi, B, et al.N-acetylcysteine augmentation in serotonin reuptake inhibitor refractory obsessive-compulsive disorder. Psychopharmacology (Berl). 2006;184:254–256.CrossRefGoogle ScholarPubMed
7.Grant, JE, Kim, SW, Odlaug, BL. N-acetyl cysteine, a glutamate-modulating agent, in the treatment of pathological gambling: a pilot study. Biol Psychiatry. 2007;62:652–657.CrossRefGoogle ScholarPubMed
8.LaRowe, SD, Myrick, H, Hedden, S, et al.Is cocaine desire reduced by N-acetylcysteine? Am J Psychiatry. 2007;164:1115–1117.CrossRefGoogle ScholarPubMed
9.Mardikian, PN, LaRowe, SD, Hedden, S, Kalivas, PW, Malcolm, RJ. An open-label trial of N-acetylcysteine for the treatment of cocaine dependence: a pilot study. Prog Neuropsychopharmacol Biol Psychiatry. 2007;31:389–394.CrossRefGoogle ScholarPubMed
10.Berk, M, Ng, F, Dean, O, Dodd, S, Bush, Al. Glutathione: a novel treatment target in psychiatry. Trends Pharmacol Sci. 2008;29:346–351.CrossRefGoogle ScholarPubMed
11.Berk, M, Copolov, D, Dean, O, et al.N-acetyl cysteine as a glutathione precursor for schizophrenia--a double-blind, randomized, placebo-controlled trial. Biol Psychiatry. 2008;64:361–368.Google Scholar
12.Berk, M, Copolov, DL, Dean, O, et al.N-acetyl cysteine for depressive symptoms in bipolar disorder--a double-blind randomized placebo-controlled trial. Biol Psychiatry. 2008;64:468–475.CrossRefGoogle ScholarPubMed
13.Ng, F, Berk, M, Dean, O, Bush, Al. Oxidative stress in psychiatric disorders: evidence base and therapeutic implications. Int J Neuropsychopharmacol. 2008;11:851–876.Google Scholar
14.McFarland, K, Lapish, CC, Kalivas, PW. Prefrontal glutamate release into the core of the nucleus accumbens mediates cocaine-induced reinstatement of drug-seeking behavior. J Neurosci. 2003;23:3531–3537.CrossRefGoogle ScholarPubMed
15.Madayag, A, Lobner, D, Kau, KS, et al.Repeated N-acetylcysteine administration alters plasticity-dependent effects of cocaine. J Neurosci. 2007;27:13968–13976.Google Scholar
16.Baptista, MA, Martin-Fardon, R, Weiss, F. Preferential effects of the metabotropic glutamate 2/3 receptor agonist LY379268 on conditioned reinstatement versus primary reinforcement: comparison between cocaine and a potent conventional reinforcer. J Neurosci. 2004;24:4723–4727.CrossRefGoogle Scholar
17.Bossert, JM, Liu, SY, Lu, L, Shaham, Y. A role of ventral tegmental area glutamate in contextual cue-induced relapse to heroin seeking. J Neurosci. 2004;24:10726–10730.Google Scholar
18.Baker, DA, McFarland, K, Lake, RW, et al.Neuroadaptations in cystine-glutamate exchange underlie cocaine relapse. Nat Neurosci. 2003;6:743–749.CrossRefGoogle ScholarPubMed
19.Zhou, W, Kalivas, PW. N-acetylcysteine reduces extinction responding and induces enduring reductions in cue- and heroin-induced drug-seeking. Biol Psychiatry. 2008;63:338–340.Google Scholar
20.Burdo, J, Schubert, D, Maher, P. Glutathione production is regulated via distinct pathways in stressed and non-stressed cortical neurons. Brain Res. 2008;1189:12–22.CrossRefGoogle ScholarPubMed