Many children and adults with Obsessive-Compulsive Disorder experience incomplete symptom relief despite
treatment with several evidence-based interventions for OCD. Converging lines of evidence from genetic, neuroimaging,
biochemical and pharmacological studies implicate the importance of abnormalities in the glutamate symptoms in the
pathogenesis of OCD. Strong evidence suggests that oxidative stress may be important in the progression of several
psychiatric disorders, especially psychotic and affective disorders. N-acetylcysteine (NAC) is a cheap, relatively safe
over-the-counter supplement that crosses the blood-brain barrier and acts potentially as a glutamate modulating agent and
antioxidant. NAC has demonstrated efficacy in the treatment of a wide variety of psychiatric conditions in individual
randomized, controlled trials including psychosis, autism, bipolar depression, trichotillomania. A recent double-blind
placebo-controlled in adults with SRI-refractory OCD demonstrated the efficacy of NAC compared to placebo. In this
review we summarize the preclinical and clinical data demonstrating NAC is a potentially promising new
pharmacological agent in the treatment of OCD.
Keywords: Glutamate, n-acetylcysteine, obsessive-compulsive disorder, oxidative stress, review, treatment.
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