Mitochondrial modulators for obsessive-compulsive and related disorders: a systematic review and meta-analysis

source extracted confidence: high 2026-04-09
#acetylcysteine #adult #double-blind-method #female #humans

Mitochondrial modulators for obsessive-compulsive and related disorders: a systematic review and meta-analysis

Kishi et al., 2022 | Transl Psychiatry | Meta Analysis

Citation

Kishi Taro, Sakuma Kenji, Iwata Nakao. Mitochondrial modulators for obsessive-compulsive and related disorders: a systematic review and meta-analysis. Transl Psychiatry. 2022-Jun-28;12(1):263. doi:10.1038/s41398-022-02026-5

Abstract

It remains unclear whether mitochondrial modulators (MMs) are beneficial in the treatment of obsessive-compulsive and related disorders. Thus, in an attempt to answer this clinical question, we performed a systematic review and a random-effects meta-analysis of double-blind, randomized, placebo-controlled trials. The primary outcome was change in overall symptoms as measured using standardized rating scales. Other outcomes were response to treatment; improvement in anxiety-related scales scores, depression-related scale scores, Clinical Global Impression Severity Scale (CGI-S) scores, and Sheehan Disability Scale (SDS) scores; all-cause discontinuation; and individual adverse events. We calculated the standardized mean differences for continuous outcomes and risk ratios for dichotomous outcomes with 95% confidence intervals. We reviewed 17 studies (n = 629, 72.62% female; duration = 2-20 weeks; mean age = 30.47 years) of MMs: eicosapentaenoic acid (K = 1), folic acid (K = 1), lithium (K = 1), N-acetylcysteine (K = 10), inositol (K = 3), and silymarin (K = 1). MMs outperformed placebo in overall improvement in symptoms (p < 0.01) and in improving anxiety-related scale scores (p = 0.05). Subgroup analysis of individual MMs revealed that although overall symptoms were better improved by N-acetylcysteine (p < 0.01) and lithium (p = 0.04), no MMs outperformed placebo in terms of improving anxiety-related scale scores. Neither pooled nor individual MMs outperformed placebo in improving response to treatment, depression-related scale scores, CGI-S scores, SDS scores, or all-cause discontinuation. N-acetylcysteine was no more associated with a higher incidence of individual adverse events including gastrointestinal symptoms, than placebo. In conclusion, N-acetylcysteine was beneficial in the treatment of obsessive-compulsive and related disorders. However, further study with larger samples is necessary to confirm this finding.

Key Findings

However, further study with larger samples is necessary to confirm this finding.

Outcomes Measured

  • anxiety
  • depression

Population

Field Value
Population See abstract
Sample Size 629
Age Range See abstract
Condition anxiety

MeSH Terms

  • Acetylcysteine
  • Adult
  • Double-Blind Method
  • Female
  • Humans
  • Inositol
  • Lithium
  • Male
  • Obsessive-Compulsive Disorder
  • Randomized Controlled Trials as Topic

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Systematic Review
  • Vertical: milk-thistle

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09