For people with obsessive compulsive disorders the condition can be extremely exhausting. For practitioners and clinicians the condition is very frustrating to manage and to bring relief safely and reproducibly. The use of the nutrient N-Acetyl Cysteine as an adjunctive intervention has been explored in a small number of clinical trials, this review paper takes a systematic approach and brings together the evidence to help determine if this single intervention has any clinical value.
Of course as all integrated health care clinicians and practitioners understand, magic bullets, pharmaceutical or natural rarely exist in complex mental health disorders, so read this in context. Whilst preliminary evidence suggests clinical value in the use of NAC, many other agents also act on the same pathways and multiple mechanisms may need to be activated and managed simultaneously to achieve meaningful outcomes.
Four clinical trials and five case reports/series were identified. Study durations were commonly 12-weeks, using 2,400-3,000 mg/day of NAC. Overall, NAC demonstrates activity in reducing the severity of symptoms, with a good tolerability profile and minimal adverse effects. Currently there are three ongoing randomised controlled trials using NAC for OCD (two adults and one paediatric), and one for excoriation.
Encouraging results have been demonstrated from the few pilot studies that have been conducted. These results are detailed, in addition to a discussion of future potential research.
 Oliver G, Dean O, Camfield D, Blair-West S, Ng C, Berk M, Sarris J. N-acetyl cysteine in the treatment of obsessive compulsive and related disorders: a systematic review. Clin Psychopharmacol Neurosci. 2015 Apr 30;13(1):12-24.