NAC (N-acetyl-cysteine)

NAC, or N-acetyl-cysteine is an antioxidant that is used to prevent liver injury when people overdose on tylenol. But in psychiatry, it has also been found to be very helpful for treating depression, irritability in autism, obsessive thinking/OCD, skin picking, and hair pulling.

What is the mechanism by which NAC helps irritability, depression, and OCD (and other related conditions such as hair pulling and skin picking)? 
Its mechanisms in the brain are complex and still being elucidated, but it is thought to benefit by acting as a potent antioxidant, aid in mitochondrial repair (mitochondria are the cell's powerhouses), and improve cerebral blood flow.

What are other benefits of NAC outside of anxiety, OCD, skin picking, hair pulling, irritability, and depression? 
1. NAC helps the liver break down toxins by increasing the production of glutathione in the liver, which is a potent antioxidant.
2. In the lungs, NAC thins out mucous, which makes it easier to cough up debris from the lungs.
3. NAC helps prevent renal (kidney) injury which can occur with certain medications (including Lithium).

What is the dose of NAC? 
In teens & adults the goal dose is usually 2400-3600mg/day, split into 2 doses.
I recommend starting with 600mg 2x per day for 1 week, then increase to 1200mg 2x per day there on.

Where can I buy NAC? 
Amazon stopped selling it but two excellent brands that you can buy online are: 
-NOW Brand NAC
-Pure Encapsulations NAC
-It can taste a little rough, but here is a powder version if the tablets are hard to swallow.

Is NAC well tolerated? 
Yes it is. According to this study, there are really very minimal, if any, side effects. That said, watch for any complaints of GI upset, headaches, or other symptoms that can come up anytime we are introducing a new medicine or supplement.