Effects of NAC on metabolic profiles
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DISORDERS
Our study indicated that taking NAC for 12 weeks in outpatients with SUD under MMT resulted in a significant reduction in HOMA‐IR, hs‐CRP levels, and a significant increase in GSH and TAC levels; however, it did not influence other metabolic profiles. Methadone therapy is linked to some disorders, including enhanced inflammatory cytokines levels (Chan et al., The main strengths of the recent study were the use of a randomized double‐blind placebo‐controlled design and the fact that the planned study sample outpatients with SUD under MMT was achieved. In addition, not any changes in the type and dosages of MMT throughout the study period enhanced the generalizability and clinical utility of the results. However, several shortcomings of the clinical trials should be considered. First of all, the small size of investigated patients might be insufficient to show an effect of NAC administration in improved metabolic profiles and psychological scores in outpatients with SUD under MMT. Second, this trial had a relatively short duration of intervention. Third, we tested only one dose of NAC. Therefore, different doses of NAC should be examined, larger studies should be conducted with larger sample sizes and longer duration of intervention, as well as intervention in different addictions (e.g., cocaine, methamphetamine, and cannabis) are required to more precisely shed light. Also, we did not evaluate the cognitive function, relapses, craving, pain, and gene expression involved in metabolic profiles especially markers related to NF‐ĸB signaling pathways in outpatients with SUD under MMT. Unfortunately, because of limited funding, we did not examine the effects of NAC supplementation on these measures and it is suggested for a future study.