ClinicalTrials.gg
Not yet recruitingNCT07913542Updated Nov 3, 2026

N-Acetylcysteine for Bipolar and Alcohol Use Disorders

A Phase 2 interventional study of N-acetyl cysteine and Placebo in Bipolar Disorder and Alcohol Use Disorder, sponsored by Medical University of South Carolina. Not yet recruiting at 1 site in United States. Open to participants aged 18 Years to 60 Years. Per ClinicalTrials.gov, last updated 2026-11-03.

Sponsored by Medical University of South Carolina · Phase 2, Interventional, and Treatment

Updated Nov 3, 2026Newly registeredGo to Updates ↓
Phase
Phase 2
Study type
Interventional
Enrollment
70
Allocation
Randomized
Ages
18 Years to 60 Years
Sex
All
01

Study summary

This study will evaluate N-acetylcysteine (NAC) in adults with bipolar disorder and alcohol use disorder. Participants will be randomly assigned to receive NAC or matched placebo for 28 days. The study includes five visits and three MRI brain imaging scans. Questionnaires, clinical interviews, alcohol and drug assessments, laboratory testing, and monitoring for possible side effects will be completed during study visits.

Read the detailed description

This randomized, placebo-controlled, double-blind, parallel-group mechanistic clinical trial will evaluate adjunctive N-acetylcysteine (NAC) in adults with co-occurring bipolar disorder and alcohol use disorder. The study is designed to examine whether NAC changes dorsal anterior cingulate cortex glutamate and glutathione homeostasis and brain activation to alcohol cues, and whether those changes are associated with reductions in heavy drinking and depressive symptoms. Participants will complete a baseline evaluation, a pretreatment MRI visit, MRI visits at 14 and 28 days after treatment begins, and a safety visit within 72 hours after the day 28 visit. Study procedures include clinical interviews, self-report questionnaires, alcohol and drug assessments, blood and urine collection, and proton magnetic resonance spectroscopy and functional MRI. Treatment assignment details, intervention records, and outcome-measure records are intentionally left for study-team completion.

02

Conditions studied

  • Bipolar Disorder
  • Alcohol Use Disorder

Keywords

  • N-acetylcysteine
  • NAC
  • bipolar I disorder
  • bipolar II disorder
  • alcohol use disorder
  • heavy drinking
  • glutamate
  • glutathione
  • magnetic resonance spectroscopy
  • functional magnetic resonance imaging
03

In context

Bipolar Disorder

1,683 studies on the registry are indexed under Bipolar Disorder; 266 are open to participants now.

This study's planned enrollment of 70 is close to the median of 64 across 1,279 interventional studies indexed under Bipolar Disorder.

Browse Bipolar Disorder studies →

Lead sponsor

Medical University of South Carolina is the lead sponsor of 874 studies on the registry; 166 are open to participants now.

Of its 131 completed or terminated interventional studies of FDA-regulated products, 104 (79%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 60 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Age 18 to 60 years.
  2. Meet criteria for bipolar I or bipolar II disorder.
  3. Prescribed daily use of at least one FDA-approved mood-stabilizing medication (lithium, divalproex sodium, lamotrigine, or a second-generation antipsychotic).
  4. Meet DSM-5 criteria for current, within the past 90 days, moderate to severe alcohol use disorder.
  5. Active alcohol use in the past 14 days, with heavy drinking days on at least 50% of drinking days in the past 30 days.
  6. Able to provide and read, understand, and accurately complete assessment instruments.
  7. Willing to commit to medication treatment and follow-up assessments.
  8. Willing to abstain from antioxidant supplements for the duration of the study.

Exclusion criteria

Exclusion Criteria:

  1. Primary psychiatric diagnosis other than bipolar disorder.
  2. Uncontrolled neurological condition that could confound study results.
  3. History of brain injury with loss of consciousness greater than 5 minutes.
  4. History of intellectual disability or dementia.
  5. Uncontrolled medical condition that may adversely affect study conduct or participant safety.
  6. Hepatocellular disease as defined in the protocol.
  7. Renal insufficiency as defined in the protocol.
  8. Concomitant use of nitroglycerin, carbamazepine, or another medication deemed hazardous with NAC.
  9. Concomitant use of specified alcohol-use-disorder medications or medications that could interfere with glutamate transmission.
  10. Electroconvulsive therapy in the past 3 months.
  11. Medication dose change of 20% or greater within 2 weeks before testing.
  12. Pregnancy, lactation, or refusal to use adequate when applicable.
  13. Current suicidal or homicidal risk.
  14. Baseline MADRS score greater than 35 or YMRS score greater than 25.
  15. alcohol withdrawal symptoms or autonomic instability.
  16. NAC use in the last month or prior adverse effects from NAC.
  17. Has an allergy to riboflavin
  18. Significant claustrophobia or prior negative experience with MRI.
  19. Non-MRI-safe material in the body.
Terms in these criteria, in plain language(4)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

DSM diagnostic criteria

The American Psychiatric Association’s manual of mental health diagnoses. DSM-5 (2013, revised as DSM-5-TR in 2022) replaced DSM-IV, and some studies still name the older edition. “Meets DSM criteria for …” means diagnosed by that edition’s diagnostic criteria, usually by a clinician in an interview.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Participant, Care provider, Investigator)
Enrollment
70 participants (estimated)

Study arms

  • Experimental
    Group A - N-Acetylcysteine

    After group assignment but before taking any study medication, participants will have a Magnetic Resonance Imaging (MRI) exam after completing various assessments (clinical interview, questionnaires, etc.). Group A will receive N-Acetylcysteine (NAC) 2 times a day for a total of 28 days. They will have follow up MRIs on day 14 and 28.

    Drug: N-acetyl cysteine

  • Placebo comparator
    Group B - Placebo

    After group assignment but before taking any study medication, participants will have a Magnetic Resonance Imaging (MRI) exam after completing various assessments (clinical interview, questionnaires, etc.). Group B will receive Placebo 2 times a day for a total of 28 days. They will have follow up MRIs on day 14 and 28.

    Drug: Placebo

Interventions

  • 28 days of NAC taken 2 times per day with MRI on days 1 (pre medication dosing), 14, and 28

  • DrugPlacebo

    28 days of Placebo taken 2 times per day with MRI on days 1 (pre medication dosing), 14, and 28

06

What researchers measure

Primary outcomes

  1. Change in dACC glutamate/glutathione levels through Proton Magnetic Resonance

    Concentrations of glutamate and glutathione in the dorsal anterior cingulate cortex will be measured on day 1, 14, and 28.

    Time frame: Baseline to end of treatment, approximately 28 days

07

Study locations

1 site
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

1 registry update since Sep 25, 2026
Registered
First appeared on the registry. No changes since
Nov 3, 2026
Show all 1 update
  1. Nov 3, 2026
    First appeared on the registry

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT07913542
Responsible party
James Prisciandaro (Principal Investigator, Medical University of South Carolina) — Principal investigator
First posted
Nov 3, 2026
Start date
Jan 1, 2027 (estimated)
Primary completion
Aug 31, 2031 (estimated)
Completion
Aug 31, 2031 (estimated)
Last update
Nov 3, 2026

Study contacts

Sara Hix
Contact
hixs@musc.edu
843-792-0572
James J. Prisciandaro, Ph.D.
principal investigator · Medical University of South Carolina

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is not yet recruiting, as verified in Oct 2026. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Studies of the drug tested here: Acetylcysteine

Start the discussion