ABSTRACT
OBJECTIVE: There is accumulating evidence that adjunctive treatment with N-acetylcysteine may be effective for schizophrenia. This study aimed to conduct a comprehensive meta-analysis examining the efficacy of randomised control trials investigating N-acetylcysteine as an adjunct treatment for schizophrenia and the first to investigate cognition as an outcome. METHODS: We systematically reviewed Medline, EmCare, PsycINFO, Embase, CINAHL Complete, China Knowledge Resource Integrated Database and the Cochrane Clinical Trials online registry for randomised control trials of N-acetylcysteine for schizophrenia. We undertook pairwise meta-analyses of N-acetylcysteine vs placebo for psychosis symptoms and cognition. RESULTS: Seven studies, including n = 220 receiving N-acetylcysteine and n = 220 receiving placebo, met inclusion criteria for the pairwise meta-analyses. Positive and Negative Syndrome Scale negative and total scores were significantly improved in the N-acetylcysteine group after 24 weeks of treatment. The cognitive domain of working memory improved with N-acetylcysteine supplementation. CONCLUSION: Evidence supports the notion that N-acetylcysteine may be a useful adjunct to standard treatment for the improvement of schizophrenia symptoms, as well as the cognitive domain of working memory. Treatment effects were observed at the later time point (⩾24 weeks), suggesting that longer interventions are required for the success of N-acetylcysteine treatment.
Subject(s)
Psychotic Disorders , Schizophrenia , Acetylcysteine/therapeutic use , Cognition , Humans , Memory, Short-Term , Randomized Controlled Trials as Topic , Schizophrenia/drug therapyABSTRACT
OBJECTIVE: Evaluate the efficacy of Collaborative Assessment and Management of Suicidality (CAMS) in managing suicide risk and deliberate self-harm in adults. METHODS: Ten databases were searched for publications referring to CAMS or the Suicide Status Form. Results were evaluated by two reviewers. RESULTS: Limited evidence that CAMS is effective in reducing suicide risk and deliberate self-harm in adult populations. CONCLUSIONS: Although CAMS appears to show promise in managing suicidal patients across a range of measures, further evidence is needed to clarify its efficacy in managing suicide risk and deliberate self-harm.
