N-Acetyl Cysteine (NAC)

[StillHopeful]

Hi -

 

I was just wondering if anyone is using N-Acetyl Cysteine (NAC) for their children's OCD symptoms? A psychologist recommended it for my DS12 but I forgot the dosage. If you are using it please let me know if you saw any improvement and how much you are giving your child. Also, how large are the pills (ex M & M size...)? No sense in me buying it if he can't/won't take it. Thank you!

[MomWithOCDSon]

Yes, my DS takes NAC daily and has been for over 2 years now. He is "adult-sized," so he takes an adult dose as utilized in a trial conducted by the NIMH and Yale a few years back. There was also one conducted for kids, with a different dosage.

 

He takes a total of 3,000 mg. per day: 1,800 in the morning and 1,200 at dinner. They're gelcaps, so they're not as big round as an M&M, but longer . . . sort of a typical gelcap size in my mind. We use the Vitamin Shoppe brand.

 

In our case, it has helped mellow out some of the OCD. Just be aware, if your child by any chance takes another other dopamenergic or serotonergic meds or supplements (glutathione, SSRIs, inositol, GABA, etc.) that, because NAC works in the same "chain" of neurotransmitters and agents (it's a precursor for glutathione), that you'll need to watch your dosing of NAC. At least that's what our psych has told us. Otherwise, you might get an activation response.

 

Here're the trial descriptions which we referenced for dosage:

 

NAC for Pediatric OCD

 

NAC for Adult OCD

 

Good luck!

[smartyjones]

In our case, it has helped mellow out some of the OCD. Just be aware, if your child by any chance takes another other dopamenergic or serotonergic meds or supplements (glutathione, SSRIs, inositol, GABA, etc.) that, because NAC works in the same "chain" of neurotransmitters and agents (it's a precursor for glutathione), that you'll need to watch your dosing of NAC. At least that's what our psych has told us. Otherwise, you might get an activation response.

 

 

sorry still -- i don't want to derail your post, Mom is just so knowledgable!!!

 

 

Mom -- a year or so ago, i think largely due to your promotion, i was investigating inositol or NAC for ds. we see an integrative MD who does a type of energetic testing -- he thought both were not good options for ds. so i didn't try them. late summer, ds started a new protocol with another integrative MD using vitamins and minerals. he suggested GABA for times of high stress, either taken at those times or taken regularly. ds son showed extreme activation from this at only 1/2 dose suggested. we did 2x and decided didn't need to try for 3rd to confirm. at appt with other doc, energy testing showed extreme no go for ds for GABA.

 

so - i'm interested if you have any thoughts you can read into this based on what you mention above. he does not take others that you mention - so i'm thinking this is his either neuortransmitter make-up or off balance. what do you mean by 'etc'. do you have studies or papers that discuss this? would we assume ds has excess dopamine and/or serotonin?

 

i began taking the GABA and was feeling good results from it -- at 250 mg. i recently got a new one at 500(original dose for ds) and have only taken it once but the afternoon i took it, i felt quite irritable. havnen't tried again.

[MomWithOCDSon]

Mom -- a year or so ago, i think largely due to your promotion, i was investigating inositol or NAC for ds. we see an integrative MD who does a type of energetic testing -- he thought both were not good options for ds. so i didn't try them. late summer, ds started a new protocol with another integrative MD using vitamins and minerals. he suggested GABA for times of high stress, either taken at those times or taken regularly. ds son showed extreme activation from this at only 1/2 dose suggested. we did 2x and decided didn't need to try for 3rd to confirm. at appt with other doc, energy testing showed extreme no go for ds for GABA.

 

so - i'm interested if you have any thoughts you can read into this based on what you mention above. he does not take others that you mention - so i'm thinking this is his either neuortransmitter make-up or off balance. what do you mean by 'etc'. do you have studies or papers that discuss this? would we assume ds has excess dopamine and/or serotonin?

 

i began taking the GABA and was feeling good results from it -- at 250 mg. i recently got a new one at 500(original dose for ds) and have only taken it once but the afternoon i took it, i felt quite irritable. havnen't tried again.

 

Smarty --

 

I'll look in my research library and see what I can find, though I am still a long way from understanding all this neurotransmitter stuff myself. Some things are precursors to other things, some things are agonists while others are antagonists . . . it all makes my head spin!

 

Frankly, I think LLM understands this stuff far better than I do. Do you remember a thread not too long ago, along these same lines? I don't recall if it was specifically about NAC and why some kids respond well to it while some others respond poorly, but she hit upon a piece of the methylation cycle that might also play into how one's body responds to the introduction of some of these supplements. I remember being struck by how that might make sense in terms of some of the reactions we've all seen and/or read about.

 

In a strictly KISS (keep it simple, Stupid) understanding of my own, I kind of boil it down to this: NAC is a precursor to glutathione. Glutathione, according to Dr. Perlmutter, improves the "efficiency of dopamine in the brain and also increases the sensitivity to dopamine and serotonin." So, if you/ your child already has enough dopamine and/or serotonin in the brain, then the addition of NAC or other agents that either increase levels or make them "more efficient" may result in activation/aggravation.

 

It appears, in my DS's case, that he doesn't have excess serontonin given as he takes both a low-dose SSRI and NAC, both to his benefit. I think, however, that some of LLM's research might suggest that were we to be successful in adjusting his methylation, he might "naturally," without meds, better balance his serotonin/dopamine levels on his own. That the SSRI may be inhibiting him from doing just that. But how we get from "here" to "there" without grave risk in terms of quality of life? I'm just not sure. So we trudge on along our now well-worn path, for better or worse.

[StillHopeful]

Derail all you want Smarty - the more anyone asks, the more we all learn!

 

I am probably going to try the NAC but I want to taper down on the SSRI first which I think is making him worse. It certainly isn't helping with anxiety or OCD. We also, tried inositol last year (same Dr. recommended it) but I found it made no difference. Thanks Mom!

[LNN]

I too will have to dust off the library of bookmarks. I have the same recall as Nancy - some time back, we stumbled on something that made us go "yes, of course - maybe that's why it works for her son but made my DD nuts" But I can't remember what that AHA tidbit was.

 

My DD tried it a year ago, long before we tackled methylation. So maybe it would work differently for her now, but we don't have any OCD or anxiety anymore, so no need to go there. The one thing to keep in mind is that NAC is sort of like a swiss army knife. It does more than one thing in the body. It's an important pre-cursor to glutathione but it also plays some role in the neurotransmitter realm. It's also a mucus-thinner and could play some role in a biofilm protocol. So one theory I had at the time of my DDs poor response was that if she had a chronic infection hiding in a biofilm (and she does have frequent sinus issues), then using NAC could erode the film and cause a herx. When I dug deeper, it was like pulling at a loose thread. NAC touches several processes that crossed my googling path that I ended up walking away from it because there were other things we could use that were "simpler" in their actions.

 

I don't discourage anyone wanting to try it. I just toss out the possibility that if you don't like what you see, it may not be easy to figure out why it didn't work. Even tho I didn't like what I saw in DD, it only took a few days after we stopped to see her regain her balance. No long lasting effects, except to my bulging cabinet of "things that didn't work". (plus - it's all about balance - it's also possible we just used too much).

Edited November 13, 2012 by LLM

[MomWithOCDSon]

I forgot to mention a couple of other things regarding NAC, as well.

 

Firstly, I would start pretty low on the dose and titer up slowly to the recommended dosage; if you go straight at a full dose, it is likely to cause intestinal distress.

 

Also, when we first started NAC a couple of years ago, I recall reading/being told that it's important that you also give Vitamin C. I don't recall exactly why, and I'm looking for the reference in this regard but thus far haven't found it. I think it has something to do with the breakdown of the NAC in the system and successfully dealing with some by-product? I CAN tell you that a freshly opened bottle of the stuff smells somewhat "sulfurous," so maybe that's part of the issue?

 

Just something to look into/check/ask your doctor about.