N-acetylcysteine for treatment of autism, a case report
The patient is an eight-year-old boy who was referred to Hafez Hospital at Shiraz, Iran, in 2011. He was diagnosed with autism disorder according to the DSM- IV diagnostic criteria.[] There was marked limited verbal communication and skills, stereotypic behaviors, restricted interest, and a significant impairment in social relationships and interactions. He also displayed hyperactivity and inattentiveness in preschool. From two years ago, oral risperidone 2 mg/day and oral thioridazine 10 mg/day were administered, to control his hyperactivity and inattentiveness. No neurological or significant medical problems were found. His laboratory examination was unremarkable.\nAfter a written informed consent form was provided by the parents, for participation of the child in a clinical trial (Irct registration number: IRCT201103023930N3), oral NAC 800 mg per day (Pharma Chimi, Iran) was added for management of his severe nail-biting behavior. There was a significant reduction in his nail-biting behavior. In addition, the parents noticed that there was a marked reduction in his autism symptoms 30 days after the onset of NAC administration. The visual analog scale showed that his social interaction was significantly increased and he responded to social interactions better than at the baseline. According to his parents’ report, the score of social impairment on the visual analog scale decreased from 10 to 6 in the two-month trial. The parents also reported that his verbal skills and communications increased from 5 to 9 after using the visual analog scale. The aggressive behaviors decreased from 10 to 3. His aggression toward his sister also significantly decreased. The parents had not marked a complaint about their children’s aggressive behavior on the last visit. In addition, his hyperactivity and limited interests were reduced after taking NAC. His preoccupation with a toy car was decreased and he was interested in playing with different toys. He had persuaded his parents to cut his hair every day before administration of NAC. They had to even cut his hair more than once a day. Now, his interest and persuasion to cut his hair was markedly deceased. Moreover, the severity and frequency of his blinking tic decreased. The parents did not report any side effect, except a mild abdominal pain. He had never experienced this type of significant improvement in the last few years, even after taking risperidone. They also reported that nothing worsened after the administration of NAC. He did not take any other antioxidant or glutathione prodrug during the period of study or for weeks before.