Bipolar DisorderPhase 2NCT07913542
N-Acetylcysteine for Bipolar and Alcohol Use Disorders
A Phase 2 study testing N-acetyl cysteine in people with Bipolar Disorder and Alcohol Use Disorder, run by Medical University of South Carolina at 1 site in United States.
Trial 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. Read more about this study
- Who is it for?
- Ages 18 to 60 years
- Conditions the study is for
- Bipolar Disorder, Alcohol Use Disorder
- What is being tested?
- N-acetyl cysteine
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 70 participants
- Where
- 1 siteUnited States
- Study dates
- 1 Jan 2027to 31 Aug 2031
- Phase
- Phase 2
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 60 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Age 18 to 60 years.
- Meet DSM-5 criteria for bipolar I or bipolar II disorder.
- Prescribed daily use of at least one FDA-approved mood-stabilizing medication (lithium, divalproex sodium, lamotrigine, or a second-generation antipsychotic).
- Meet DSM-5 criteria for current, within the past 90 days, moderate to severe alcohol use disorder.
- Active alcohol use in the past 14 days, with heavy drinking days on at least 50% of drinking days in the past 30 days.
- Able to provide informed consent and read, understand, and accurately complete assessment instruments.
- Willing to commit to medication treatment and follow-up assessments.
- Willing to abstain from antioxidant supplements for the duration of the study.
Who cannot join
- Primary psychiatric diagnosis other than bipolar disorder.
- Uncontrolled neurological condition that could confound study results.
- History of brain injury with loss of consciousness greater than 5 minutes.
- History of intellectual disability or dementia.
- Uncontrolled medical condition that may adversely affect study conduct or participant safety.
- Hepatocellular disease as defined in the protocol.
Show all 19Show fewer
- Renal insufficiency as defined in the protocol.
- Concomitant use of nitroglycerin, carbamazepine, or another medication deemed hazardous with NAC.
- Concomitant use of specified alcohol-use-disorder medications or medications that could interfere with glutamate transmission.
- Electroconvulsive therapy in the past 3 months.
- Medication dose change of 20% or greater within 2 weeks before testing.
- Pregnancy, lactation, or refusal to use adequate contraception when applicable.
- Current suicidal or homicidal risk.
- Baseline MADRS score greater than 35 or YMRS score greater than 25.
- Clinically significant alcohol withdrawal symptoms or autonomic instability.
- NAC use in the last month or prior adverse effects from NAC.
- Has an allergy to riboflavin
- Significant claustrophobia or prior negative experience with MRI.
- Non-MRI-safe material in the body.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
United States1 site
Medical University of South Carolina
Charleston, South Carolina, 29425
Sara Hix
About this study
Official title: N-acetylcysteine for Restoring Glutamate/Glutathione Homeostasis and Reducing Heavy Drinking in Co-occurring Bipolar and Alcohol Use Disorders
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.
- Conditions
- Bipolar Disorder, Alcohol Use Disorder
- Being tested
- N-acetyl cysteine, Placebo
- Keywords
- N-acetylcysteine, NAC, bipolar I disorder, bipolar II disorder, alcohol use disorder, heavy drinking, glutamate, glutathione, magnetic resonance spectroscopy, functional magnetic resonance imaging
- Medical subject headings
- Bipolar Disorder, Alcoholism
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
N-acetyl cysteineDrug
28 days of NAC taken 2 times per day with MRI on days 1 (pre medication dosing), 14, and 28
PlaceboDrug
28 days of Placebo taken 2 times per day with MRI on days 1 (pre medication dosing), 14, and 28
| Study group | Role | What they receive |
|---|---|---|
| Group A - N-Acetylcysteine | Experimental | 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. Receives: Drug: N-acetyl cysteine |
| Group B - Placebo | Placebo comparator | 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. Receives: Drug: Placebo |
What is being measured
The primary outcome is the main question the study is designed to answer.
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.
Measured: Baseline to end of treatment, approximately 28 days
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted3 Nov 2026
- Study start1 Jan 2027 (estimated)
- Primary completion31 Aug 2031 (estimated)
- Study completion31 Aug 2031 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Bipolar DisorderStudies of the same condition, open and under way.
- More trials run by Medical University of South CarolinaThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind
- Who is masked
- Participant, Care provider, Investigator
- Enrolment
- 70 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Medical University of South Carolina
- Sponsor type
- University, hospital or other
- Collaborators
- National Institute on Alcohol Abuse and Alcoholism (NIAAA)
- Responsible party
- Principal investigator, James Prisciandaro, Medical University of South Carolina
- Investigators
- James J. Prisciandaro, Ph.D., Principal investigator, Medical University of South Carolina
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07913542
- Sponsor's protocol ID
- Pro00153022
- Status last verified
- Oct 2026
- First submitted
- 27 Oct 2026
- Last updated
- 3 Nov 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 3 Nov 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- N-acetylcysteine for Restoring Glutamate/Glutathione Homeostasis and Reducing Heavy Drinking in Co-occurring Bipolar and Alcohol Use Disorders
- ClinicalTrials.gov ID
- NCT07913542
- Acronym / sponsor ID
- Pro00153022
- Conditions
- Bipolar Disorder, Alcohol Use Disorder
- Keywords
- N-acetylcysteine, NAC, bipolar I disorder, bipolar II disorder, alcohol use disorder, heavy drinking, glutamate, glutathione
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 70 participants (estimated)
- Lead sponsor
- Medical University of South CarolinaUniversity, hospital or other
- Collaborators
- National Institute on Alcohol Abuse and Alcoholism (NIAAA)
- Study start
- 1 Jan 2027 (estimated)
- Primary completion
- 31 Aug 2031 (estimated)
- Study completion
- 31 Aug 2031 (estimated)
- First posted
- 3 Nov 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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.
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.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind (participant, care provider, investigator)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Group A - N-Acetylcysteine | Experimental | Drug: N-acetyl cysteineAfter 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. |
| Group B - Placebo | Placebo comparator | Drug: PlaceboAfter 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. |
Who may qualify
- Ages
- 18 to 60 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (8 listed)
- Age 18 to 60 years.
- Meet DSM-5 criteria for bipolar I or bipolar II disorder.
- Prescribed daily use of at least one FDA-approved mood-stabilizing medication (lithium, divalproex sodium, lamotrigine, or a second-generation antipsychotic).
- Meet DSM-5 criteria for current, within the past 90 days, moderate to severe alcohol use disorder.
- Active alcohol use in the past 14 days, with heavy drinking days on at least 50% of drinking days in the past 30 days.
Key exclusion criteria (19 listed)
- Primary psychiatric diagnosis other than bipolar disorder.
- Uncontrolled neurological condition that could confound study results.
- History of brain injury with loss of consciousness greater than 5 minutes.
- History of intellectual disability or dementia.
- Uncontrolled medical condition that may adversely affect study conduct or participant safety.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| N-acetyl cysteine28 days of NAC taken 2 times per day with MRI on days 1 (pre medication dosing), 14, and 28 | Drug | Group A - N-Acetylcysteine |
| Placebo28 days of Placebo taken 2 times per day with MRI on days 1 (pre medication dosing), 14, and 28 | Drug | Group B - Placebo |
Primary outcome
Change in dACC glutamate/glutathione levels through Proton Magnetic Resonance
Time frame: Baseline to end of treatment, approximately 28 days
Concentrations of glutamate and glutathione in the dorsal anterior cingulate cortex will be measured on day 1, 14, and 28.
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 3 Nov 2026.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
James J. Prisciandaro, Ph.D. principal investigator
Medical University of South Carolina
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing N-acetyl cysteine in people with Bipolar Disorder and Alcohol Use Disorder, run by Medical University of South Carolina at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 8 inclusion and 19 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 3 Nov 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Sara Hix (843-792-0572, hixs@musc.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change in dACC glutamate/glutathione levels through Proton Magnetic Resonance (time frame: Baseline to end of treatment, approximately 28 days). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 3 Nov 2026.