Condition
Cocaine Abuse
Cocaine use disorder is compulsive cocaine use despite harm, as repeated dopamine surges leave the brain with fewer dopamine receptors, fueling tolerance and craving. N-acetyl cysteine has the strongest evidence among supplements, with omega-3 fatty acids moderate, and in one placebo-controlled trial of 73 cocaine-dependent volunteers, citicoline improved addiction symptoms. That citicoline evidence is limited, resting on a single small study, so it is an early signal rather than a firm answer.
Sources: PMID 21769048
- Supplements studied
- 2
- Graded outcomes
- 2
- Trials
- 3
- People studied
- 86
Evidence by supplement
- Strong
- Moderate
- Limited
- Very limited
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Cocaine Addiction Symptoms Small improvement in addiction markers | Improves (the measure goes down) | Small effect | 1 study | 73 people | ||
Studies that measured cocaine addiction symptoms | ||||||
| Bipolar Disorder Symptoms No effect | NoneNo effect | 1 study | 44 people | |||
Studies that measured bipolar disorder symptoms | ||||||
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Cocaine Addiction Symptoms | Improves (the measure goes down) | 2 studies | 13 people | |||
Studies that measured cocaine addiction symptoms | ||||||
Key findings
- Cocaine Addiction SymptomsImproves (the measure goes down)
- Bipolar Disorder Symptoms
The Cocaine Use Disorder Recovery Support protocol
2 primary supplements · 7 supporting supplements
- N-Acetyl Cysteine (NAC)1,200–2,400 mg daily in divided doses
- Omega-3 Fatty Acids2–4 g EPA+DHA daily
Studies cited
40 studies from PubMed
- Evidence of the neuroprotective role of citicoline in glaucoma patients
- A randomized, placebo-controlled trial of citicoline add-on therapy in outpatients with bipolar disorder and cocaine dependence
- Effects of daily treatment with citicoline: a double-blind, placebo-controlled study in cocaine-dependent volunteers
- Citicoline affects appetite and cortico-limbic responses to images of high-calorie foods
- Citicoline improves memory performance in elderly subjects
- Citicoline improves verbal memory in aging
- Safety and tolerability of N-acetylcysteine in cocaine-dependent individuals
- The administration of N-acetylcysteine reduces oxidative stress and regulates glutathione metabolism in the blood cells of workers exposed to lead
- N-Acetylcysteine Attenuates Fatigue Following Repeated-Bouts of Intermittent Exercise: Practical Implications for Tournament Situations
- N-acetylcysteine, a glutamate modulator, in the treatment of trichotillomania: a double-blind, placebo-controlled study
- New developments in the treatment of COPD: comparing the effects of inhaled corticosteroids and N-acetylcysteine
- Induced sputum of patients with chronic obstructive pulmonary disease (COPD) contains adhesion-promoting, therapy-sensitive factors
- N-acetylcysteine add-on treatment in refractory obsessive-compulsive disorder: a randomized, double-blind, placebo-controlled trial
- Systematic review and meta-analysis of the efficacy of N-acetylcysteine in the treatment of acute exacerbation of chronic obstructive pulmonary disease.
- Effects of N-acetylcysteine on outcomes in chronic obstructive pulmonary disease (Bronchitis Randomized on NAC Cost-Utility Study, BRONCUS): a randomised placebo-controlled trial
- Long-term oral n-acetylcysteine reduces exhaled hydrogen peroxide in stable COPD
- The efficacy of -acetylcysteine in chronic obstructive pulmonary disease patients: a meta-analysis.
- Effect of Orally Administered N-Acetylcysteine on Chronic Bronchitis: A Meta-analysis.
- A randomized controlled pilot trial of oral N-acetylcysteine in children with autism
- A randomized double blind placebo controlled clinical trial of N-Acetylcysteine added to risperidone for treating autistic disorders
- N-Acetylcysteine (NAC) inhibits renal nitrite and nitrate reabsorption in healthy subjects and in patients undergoing cardiac surgery: risk of nitric oxide (NO) bioavailability loss by NAC?
- The role of cystine-glutamate exchange in nicotine dependence in rats and humans
- N-acetylcysteine (NAC) in young marijuana users: an open-label pilot study
- N-Acetylcysteine in depressive symptoms and functionality: a systematic review and meta-analysis.
- N-acetylcysteine in the treatment of craving in substance use disorders: Systematic review and meta-analysis.
- Meta-analysis of randomised controlled trials with -acetylcysteine in the treatment of schizophrenia.
- Meta-analytic Techniques to Assess the Association Between N-acetylcysteine and Acute Kidney Injury After Contrast Administration: A Systematic Review and Meta-analysis.
- The efficacy of adjuvant N acetyl cysteine for the eradication of H pylori infections: A systematic review and meta-analysis of randomized clinical trials.
- N-acetylcysteine in the Donor, Recipient, or Both Donor and Recipient in Liver Transplantation: A Systematic Review With Meta-analysis and Trial Sequential Analysis.
- N-acetylcysteine use among patients undergoing cardiac surgery: A systematic review and meta-analysis of randomized trials.
- The effect of N-acetylcysteine on bipolar depression: a systematic review and meta-analysis of randomized controlled trials.
- N-acetylcysteine as an adjunctive treatment for bipolar depression: A systematic review and meta-analysis of randomized controlled trials.
- N-acetylcysteine as an adjunctive treatment for bipolar depression and major depressive disorder: a systematic review and meta-analysis of double-blind, randomized placebo-controlled trials.
- Efficacy and Safety of N-Acetylcysteine for the Management of Chronic Pain in Adults: A Systematic Review and Meta-Analysis.
- The effects of N-acetylcysteine on ovulation and sex hormones profile in women with polycystic ovary syndrome: a systematic review and meta-analysis
- The effects of N-acetylcysteine supplement on metabolic parameters in women with polycystic ovary syndrome: a systematic review and meta-analysis.
- A systematic review and meta-analysis of the efficacy and safety of N-acetylcysteine in preventing aminoglycoside-induced ototoxicity: implications for the treatment of multidrug-resistant TB.
- Effect of N-acetyl-cysteine in prevention of noise-induced hearing loss: a systematic review and meta-analysis of randomized controlled trials.
- Effect of N-acetyl-cysteine treatment on sensorineural hearing loss: a meta-analysis.
- No Significant Beneficial Effects of Intravenous N-Acetylcysteine on Patient Outcome in Non-Paracetamol Acute Liver Failure: A Meta-Analysis of Randomized Controlled Trials.