Antioxidant Reduces PTSD Symptoms, Cravings

January 12, 2017

Adding the over-the-counter antioxidant N-acetylcysteine to cognitive behavioral therapy eased symptoms of post-traumatic stress disorder (PTSD), cravings, and depression in veterans with co-occurring PTSD and substance use disorder.

Researchers published their findings online in The Journal of Clinical Psychiatry.

The double-blind trial included 35 veterans with PTSD receiving cognitive behavioral therapy for substance use disorder. Participants were randomly assigned 2,400 mg/day of N-acetylcysteine or placebo over 8 weeks.

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    Lead study author Sudie E. Back, PhD (right)
    with co-author Peter W. Kalivas, PhD.
    Credit: Dawn Brazell        

By the trial’s end, the N-acetylcysteine group showed a 46% drop in PTSD symptoms on the Clinician-Administered PTSD Scale, compared with a 25% decrease in the placebo group, researchers reported. In addition, veterans receiving N-acetylcysteine experienced an 81% reduction in their amount of cravings and a 71% decrease in their frequency of cravings. Veterans receiving placebo, meanwhile, reported a 32% decrease in their amount of cravings and a 29% drop in their frequency of cravings.

Furthermore, depression symptoms eased by 48% in veterans taking N-acetylcysteine compared with 15% in veterans taking placebo.

At this point, researchers consider N-acetylcysteine a possible adjunct to psychotherapy and not a substitute for it.“We would not advocate using it instead of therapy,” said lead study author Sudie E. Back, PhD, a professor at the Medical University of South Carolina and a staff psychologist at the Ralph H. Johnson VA Medical Center in Charleston, SC. “But this could be something to help prevent relapse when used alongside a behavioral treatment.”

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In another new study, N-acetylcysteine seemed to ease alcohol use in young adults receiving treatment for marijuana dependence. In the 8-week trial, compensatory alcohol use during marijuana treatment decreased among participants assigned N-acetylcysteine but not among those assigned placebo.

That study, too, involved researchers from the Medical University of South Carolina. It is published in the journal Addictive Behaviors.

—Jolynn Tumolo


Back SE, McCauley JL, Korte KJ, et al. A double-blind, randomized, controlled pilot trial of N-acetylcysteine in veterans with posttraumatic stress disorder and substance use disorders. The Journal of Clinical Psychiatry. 2016 October 11;[Epub ahead of print].

Ibrahim N. Antioxidant may help veterans suffering from PTSD and substance use disorders [press release]. Charleston, SC: Medical University of South Carolina; December 16, 2016.

Squeglia LM, Baker NL, McClure EA, Tomko RL, Adisetiyo V, Gray KM. Alcohol use during a trial of N-acetylcysteine for adolescent marijuana cessation. Addictive Behaviors. 2016;63:172-177.

Kearney-Ramos T. Over-the-counter antioxidant may help teens cut back on drinking [press release]. Charleston, SC: Medical University of South Carolina; December 14, 2016.