N-acetylcysteine may reduce repetitive behaviors in children with autism: a case series

Objective: Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impairment in social communication and interaction, and restricted, stereotypic, repetitive behaviors. Behavioral problems are common in children with ASD. Herein, we report the effect of N-acetylcysteine (NAC) treatment on repetitive behaviors in 10 children with ASD.

Methods: Ten children with ASD were assessed using the Childhood Autism Rating Scale and Aberrant Behavior Checklist (ABC). The clinical follow-up was performed with ABC and Clinical Global Impressions-Improvement (CGI-I). A total of 10 patients were initiated on NAC therapy in addition to their treatment with a stable dose of risperidone to avoid the potential adverse effects of higher doses of risperidone. Two patients discontinued NAC treatment before the third week. Eight patients were treated with an NAC dosage of 1200–2700 mg/day for 6–10 weeks.

Results: The mean age of the patients was 8.6 years. Patients received NAC treatment for a mean duration of 8.25 weeks and a mean dosage of 2100 mg/day. Improvement in stereotypic behaviors was statistically significant in addition to the improvement in mean CGI-I score (p = .025 and .006, respectively).

Conclusion: NAC adjunction to risperidone treatment may be helpful to reduce repetitive behaviors in children with ASD with limited adverse effects and good tolerability