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N-acetylcysteine for patients with alcohol use disorder, post-traumatic stress disorder, and their co-occurrence: a systematic review of placebo-controlled randomized trials

Mohamed Awad E Ahmed, Mufreh Amin, Yomna Emad Abdalla, Amr Abdelghani, Nourhan Eid, Aya Samy, Omar Kassar, Khalid Radwan Alsaadany, Mohamed Ezzat M Mansour
BMC Psychiatry 2026 26(1):384

Bibliography

PubMed
PMID 42115982
PubMed Central
PMC13162469
DOI
10.1186/s12888-026-08124-8
Funding
Open-access funding was provided by the Science, Technology & Innovation Funding Authority (STDF) in cooperation with the Egyptian Knowledge Bank (EKB).
Competing interests
The authors declared no competing interests.

Study snapshot

DesignSystematic review and meta-analysis of randomized placebo-controlled trials
ModelHuman
Sample7 randomized double-blind placebo-controlled trials; 566 participants
InterventionN-acetylcysteine versus placebo as an adjunct in alcohol use disorder, PTSD or co-occurring AUD/PTSD
DurationVaried across included trials
EndpointsAlcohol craving; PTSD severity; Alcohol use; Anxiety; Depression; Biomarkers

What the study showed, in plain terms

2026 evidence synthesis of placebo-controlled NAC trials for alcohol use disorder, PTSD and their co-occurrence.

Key findings

Pooled analyses found no consistent significant benefit versus placebo for alcohol craving or PTSD severity in broad populations; NAC was relatively safe and sensitivity analyses suggested a possible PTSD signal that remains uncertain.

What this study can and cannot tell us

Only seven heterogeneous trials with differing populations and outcomes; sensitivity signals do not override the overall null pooled results.

Editorial review

Reviewed by the Biohack Blueprint research team

Last verified

Dr. Khaled Mahmoud, MBBChCritical Care Medicine, Longevity Science & Editorial Direction Dr. Amr Yasser, PhDCardiometabolic, Musculoskeletal, Gut & Bioavailability Dr. Abdulla Mostafa, PhDCellular Senescence, Neurological, Mitochondrial & Brain-Ageing Biology