However , mechanistic studies found significant improvements in hippocampal neuronal health and brain glutathione .
CONCLUSION There is preliminary evidence that taurine improves outcomes in FEP , whereas effects of omega-3 and antioxidant vitamins/amino-acids are inconsistent ; perhaps mainly benefitting patients with high levels of oxidative stress .
AIM The effects of nutrient-based treatments , including adjunctive vitamin or antioxidant supplementation , have been explored extensively in long-term schizophrenia .
However , no systematic evaluation of trials in " first-episode psychosis " ( FEP ) has been conducted , despite the potential benefits of using these treatments during the early stages of illness .
Therefore , we aim ed to review all studies examining efficacy , tolerability and the biological mechanisms of action , of nutrient supplementation in FEP .
N-acetylcysteine in a Double-Blind Randomized Placebo-Controlled Trial: Toward Biomarker-Guided Treatment in Early Psychosis
Abstract Biomarker-guided treatments are needed in psychiatry , and previous data suggest oxidative stress may be a target in schizophrenia . A previous add-on trial with the antioxidant N-acetylcysteine ( NAC ) led to negative symptom reductions in chronic patients . We aim to study NAC ’s impact on symptoms and neurocognition in early psychosis ( EP ) and to explore whether glutathione (GSH)/redox markers could represent valid biomarkers to guide treatment . In a double-blind , r and omized , placebo-controlled trial in 63 EP patients , we assessed the effect of NAC supplementation ( 2700 mg/day , 6 months ) on PANSS , neurocognition , and redox markers ( brain GSH [ GSHmPFC ] , blood cells GSH levels [ GSHBC ] , GSH peroxidase activity [ GPxBC ] ) . No changes in negative or positive symptoms or functional outcome were observed with NAC , but significant improvements were found in favor of NAC on neurocognition ( processing speed ) . NAC also led to increases of GSHmPFC by 23 % ( P = .005 ) and GSHBC by 19 % ( P = .05 ) . In patients with high-baseline GPxBC compared to low-baseline GPxBC , subgroup explorations revealed a link between changes of positive symptoms and changes of redox status with NAC . In conclusion , NAC supplementation in a limited sample of EP patients did not improve negative symptoms , which were at modest baseline levels . However , NAC led to some neurocognitive improvements and an increase in brain GSH levels , indicating good target engagement . Blood GPx activity , a redox peripheral index associated with brain GSH levels , could help identify a subgroup of patients who improve their positive symptoms with NAC . Thus , future trials with antioxidants in EP should consider biomarker-guided treatment
However , mechanistic studies found significant improvements in hippocampal neuronal health and brain glutathione .
CONCLUSION There is preliminary evidence that taurine improves outcomes in FEP , whereas effects of omega-3 and antioxidant vitamins/amino-acids are inconsistent ; perhaps mainly benefitting patients with high levels of oxidative stress .
AIM The effects of nutrient-based treatments , including adjunctive vitamin or antioxidant supplementation , have been explored extensively in long-term schizophrenia .
However , no systematic evaluation of trials in " first-episode psychosis " ( FEP ) has been conducted , despite the potential benefits of using these treatments during the early stages of illness .
Therefore , we aim ed to review all studies examining efficacy , tolerability and the biological mechanisms of action , of nutrient supplementation in FEP .