[PHNUTR-L] New study finds N-acetylcysteine helps to reduce cocaine cravings

[Kathrynne Holden, MS, RD]

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Public release date: 13-Dec-2005
http://www.eurekalert.org/pub_releases/2005-12/g-nsf_1121305.php

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New study finds common herbal supplement helps to reduce cocaine cravings

Research released at ACNP Annual Meeting

A new study funded by the National Institutes of Health (NIH) suggests 
that a common over-the-counter herbal supplement can reduce the cravings 
associated with chronic cocaine use. This research, released at the 
American College of Neuropsychopharmacology's (ACNP) annual conference 
is among the first to identify N-acetylcysteine (NAC) as a potential 
agent to modulate the effects of cocaine addiction. There is also early 
evidence in animal models of addiction to suggest that this chemical 
works similarly in the treatment of heroin addiction, and possibly 
alcoholism.

NAC is available over the counter as an herbal supplement known for its 
antioxidant effects. Antioxidants are agents that clean up damaging free 
radicals in the body and are therefore thought to slow down the aging 
process of cells. The research was conducted specifically on because of 
its known metabolic pathway in the brain – affecting one of the same 
proteins as cocaine use.

"Cocaine is highly addictive and can have devastating effects on the 
health and well being of users," says lead researcher Peter Kalivas, 
Ph.D., Professor and Chair of the Department of Neurosciences at the 
Medical University of South Carolina (MUSC). "The discovery that a 
readily available herbal supplement can reduce the intense cravings 
associated with cocaine use is an important finding for individuals 
undergoing treatment for cocaine addiction. Reduced craving might help 
addicted individuals restrain from abusing cocaine."

In the first phase of the study, Dr. Kalivas and the research team 
conditioned rats on a regimen of cocaine to establish their addiction. 
The rats in the treatment group were then treated with NAC. After 
treatment, the cocaine-addicted rats exposed to NAC were significantly 
less likely to seek out cocaine than those without NAC. Those treated 
with NAC ceased to actively seek cocaine, but showed normal food-seeking 
behaviors.

In the second phase of the study headed by Drs. Robert Malcolm, Hugh 
Myrick, Steve LaRowe, and Pascale Mardikian in the Department of 
Psychiatry at MUSC, NAC treatment was investigated in a small inpatient 
study (n=15) involving non-treatment seeking cocaine-dependent subjects. 
In this phase of research, subjects were asked to look at pictures that 
were either neutral (e.g., trees, boats) or cocaine-related (e.g., drug 
paraphernalia). Those individuals treated with NAC reported less craving 
for cocaine and spent less time looking at the cocaine-related pictures. 
In addition, when using a functional magnetic resonance imaging (fMRI) 
test, subjects treated with NAC had reduced brain activity in the 
prefrontal cortex, the area of the brain activated during cocaine 
craving and used to modulate the addictive behavior of chronic cocaine 
use. An open label trial, which was recently completed, indicated that 
cocaine-dependent patients could take NAC on an extended outpatient 
basis, with minimal side effects. More importantly, patients taking 
higher doses of NAC were more likely to complete the trial, providing 
further indication of the potential benefits of NAC.

"The potential to use NAC for the treatment of individuals addicted to 
cocaine is a major finding," emphasized Dr. Kalivas. "For those 
individuals who have the desire to end their addictive habit, a NAC 
supplement might help to control their cravings."

A larger clinical trial that will follow 282 cocaine-dependent 
individuals has just begun in order to further understand and 
corroborate how NAC works in the brain to reduce cocaine craving. Dr. 
Kalivas stresses that while the initial findings are very promising, the 
widespread use of NAC in cocaine treatment is not advised until larger 
scale studies are complete.

In addition to its antioxidant properties, NAC is currently used in a 
variety of other ways: to counteract the effects of an overdose of 
acetaminophen (i.e., Tylenol®), to break up mucus in respiratory 
ailments, to lessen the symptoms of colds or the flu, and even to reduce 
the effects of hangovers. It is important to note that over-the-counter 
NAC may not be produced in the same manner as the prescription version 
used in this study, and that all herbal supplements should be used in 
moderation.

Cocaine is an illegal drug that acts as a powerful stimulant in the 
body. There are approximately 1.5 million Americans dependent on or 
abusing cocaine (i.e., chronic users). In addition, 2.7 percent of the 
general U.S. population has tried cocaine during their lifetime. Adults 
aged 18 to 25, particularly men, have the highest rates of cocaine use.
-- 
Kathrynne Holden, MS, RD < fivestar at nutritionucanlivewith.com >
"Ask the Parkinson Dietitian"  http://www.parkinson.org/
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