Open-Label Study of N-Acetylcysteine in Children and Adolescents 5-17 With Bipolar Spectrum Disorders



Status:Completed
Conditions:Psychiatric, Bipolar Disorder
Therapuetic Areas:Psychiatry / Psychology
Healthy:No
Age Range:5 - 17
Updated:11/30/2018
Start Date:January 2014
End Date:September 24, 2018

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Open-Label Study of N-Acetylcysteine in Children and Adolescents Ages 5-17 With Bipolar I, Bipolar II, and Bipolar Spectrum Disorder

Children between the ages of 5-17 years old who have or display symptoms of emotional
dysregulation (explosiveness, mood swings, irritability, and/or violent behavior) are invited
to participate in a 12-week research study to determine the effectiveness and safety of the
natural treatment N-acetylcysteine (NAC) for children with emotional and behavioral problems.
After undergoing a comprehensive evaluation by medical doctors with a specialty in this area,
children who are found eligible to participate in this research study will be treated with
NAC. Following the evaluation period, this research study requires 12 weekly visits, either
in our office or over the phone, in an effort to closely monitor each child's response to the
medication. Eligible participants will receive study-related evaluations and weekly study
visits with our study doctors at no cost.

This will be a 12-week, open-label study of NAC in the treatment of bipolar disorder in
children and adolescents. Subjects will include youth ages 5-17 years with a bipolar spectrum
disorder (type I, II, or NOS), mixed, manic, or hypomanic state, according to the Diagnostic
and Statistical Manual of Mental Disorders, Fifth Edition DSM-5 (American Psychiatric
Association, 2013). The primary outcome measures will be improvement in manic symptoms as
measured by the Young Mania Rating Scale (YMRS) and improvement in depressive symptoms as
measured by the Child Depression Rating Scale (CDRS).

Bipolar diagnoses will be made according to the DSM-5 in a clinical evaluation by a Child
Psychiatrist and confirmed using the Schedule for Affective Disorders and Schizophrenia for
School-Age Children - Epidemiological Version (K-SADS-E)(Orvaschel, 1994). All subjects must
have a YMRS score of at least 15. Only patients who are not responding to their current
treatment regimen will be tapered from their medications; youth on concomitant psychiatric
medications will be permitted to continue those medications as listed in the concomitant
medication section.

Inclusion Criteria:

- Male or female subjects, 5-17 years of age

- Subjects must have a DSM-IV diagnosis of a bipolar spectrum disorder (type I, II, or
Not Otherwise Specified) and currently display mixed, manic, or hypomanic symptoms
(without psychotic features) according to clinical assessment based on the DSM-IV and
confirmed with structured diagnostic interview

- Subjects and their legal representative must have a level of understanding sufficient
to communicate intelligently with the investigator and study coordinator and to
cooperate with all tests and examinations required by the protocol

- Subjects and their legal representatives must be considered reliable.

- Each subject and his/her authorized legal representative must understand the nature of
the study. The subject's authorized legal representative must provide written consent
and the subject must provide written assent.

- Subjects must have an initial score on the YMRS of at least 15.

Exclusion Criteria:

- Investigator and his/her immediate family (defined as the investigator's spouse,
parent, child, grandparent, or grandchild)

- Serious or unstable illness including hepatic, rental, gastroenterological,
respiratory, cardiovascular (including ischemic heart disease), endocrinologic,
neurologic, immunologic, or hematologic disease

- Uncorrected hypothyroidism or hyperthyroidism

- History of sensitivity to N-acetylcysteine, a history of intolerance to
N-acetylcysteine, or a non-responder after 2 months of treatment at adequate doses as
determined by the clinician

- Severe allergies or multiple adverse drug reactions

- Current or past history of seizures

- Active substance abusers, per clinician judgment

- Judged clinically to be at serious suicidal risk

- Current diagnosis of schizophrenia

- Pregnancy

- C-SSRS score ≥ 4

- IQ < 70
We found this trial at
1
site
185 Cambridge Street
Boston, Massachusetts 02114
617-724-5200
Principal Investigator: Janet Wozniak, MD
Phone: 617-643-6617
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Boston, MA
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