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Old 10-16-2009, 03:43 PM   #1 (permalink)
 
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Default Nac working for OCD

I take 600mg 3 times a day, seems to take the edge of my OCD! Nac has many healt benefits too, so i suggest to use it

EDIT: Gonna keep this post updated with the latest evidence:

Quote:
http://www.springerlink.com/content/763746nj71604523/

Received: 15 October 2005 Accepted: 25 October 2005 Published online: 22 December 2005
Abstract
Rationale Dysfunction of glutamatergic neurotransmission has been implicated in the pathophysiology of obsessive-compulsive disorder (OCD) and recent clinical reports suggest that some glutamate modulating agents are efficacious in the treatment of this disorder. N-acetylcysteine (NAC) is a readily available amino acid compound that is thought to attenuate glutamatergic neurotransmission. NAC may be useful in treating psychiatric disorders involving glutamatergic dysfunction such as OCD.
Objectives To examine the efficacy of augmentation with NAC in a patient with serotonin reuptake inhibitor (SRI)-refractory OCD.
Methods A patient with SRI-refractory OCD was treated with an off-label use of NAC augmentation of fluvoxamine over several weeks.
Results NAC augmentation of fluvoxamine resulted in a marked decrease in Yale-Brown Obsessive Compulsive Scale (Y-BBOCS) score and a clinically significant improvement in OCD symptoms.
Conclusions NAC augmentation was effective in treating SRI-refractory OCD in this single case. Further research is warranted to investigate the use of NAC and other glutamate modulating agents in the treatment of OCD.
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N-acetyl cysteine as a glutathione precursor for schizophrenia--a double-blind, randomized, placebo-controlled trial.
Berk M, Copolov D, Dean O, Lu K, Jeavons S, Schapkaitz I, Anderson-Hunt M, Judd F, Katz F, Katz P, Ording-Jespersen S, Little J, Conus P, Cuenod M, Do KQ, Bush AI.

The Mental Health Research Institute of Victoria, Parkville, Australia.
BACKGROUND: Brain glutathione levels are decreased in schizophrenia, a disorder that often is chronic and refractory to treatment. N-acetyl cysteine (NAC) increases brain glutathione in rodents. This study was conducted to evaluate the safety and effectiveness of oral NAC (1 g orally twice daily [b.i.d.]) as an add-on to maintenance medication for the treatment of chronic schizophrenia over a 24-week period. METHODS: A randomized, multicenter, double-blind, placebo-controlled study. The primary readout was change from baseline on the Positive and Negative Symptoms Scale (PANSS) and its components. Secondary readouts included the Clinical Global Impression (CGI) Severity and Improvement scales, as well as general functioning and extrapyramidal rating scales. Changes following a 4-week treatment discontinuation were evaluated. One hundred forty people with chronic schizophrenia on maintenance antipsychotic medication were randomized; 84 completed treatment. RESULTS: Intent-to-treat analysis revealed that subjects treated with NAC improved more than placebo-treated subjects over the study period in PANSS total [-5.97 (-10.44, -1.51), p = .009], PANSS negative [mean difference -1.83 (95% confidence interval: -3.33, -.32), p = .018], and PANSS general [-2.79 (-5.38, -.20), p = .035], CGI-Severity (CGI-S) [-.26 (-.44, -.0, p = .004], and CGI-Improvement (CGI-I) [-.22 (-.41, -.03), p = .025] scores. No significant change on the PANSS positive subscale was seen. N-acetyl cysteine treatment also was associated with an improvement in akathisia (p = .022). Effect sizes at end point were consistent with moderate benefits. CONCLUSIONS: These data suggest that adjunctive NAC has potential as a safe and moderately effective augmentation strategy for chronic schizophrenia.
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N-acetyl cysteine for depressive symptoms in bipolar disorder--a double-blind randomized placebo-controlled trial.
Berk M, Copolov DL, Dean O, Lu K, Jeavons S, Schapkaitz I, Anderson-Hunt M, Bush AI.

The Mental Health Research Institute of Victoria, Victoria, Australia.
Comment in:

Biol Psychiatry. 2008 Nov 1;64(9):e1.
BACKGROUND: Treatment-resistant subthreshold depression is a major problem in bipolar disorder. Both depression and bipolar disorder are complicated by glutathione depletion. We hypothesized that treatment with N-acetyl cysteine (NAC), a safe, orally bioavailable precursor of glutathione, may improve the depressive component of bipolar disorder. METHODS: A randomized, double-blind, multicenter, placebo-controlled study of individuals (n = 75) with bipolar disorder in the maintenance phase treated with NAC (1 g twice daily) adjunctive to usual medication over 24 weeks, with a 4-week washout. The two primary outcomes were the Montgomery Asberg Depression Rating Scale (MADRS) and time to a mood episode. Secondary outcomes included the Bipolar Depression Rating Scale and 11 other ratings of clinical status, quality of life, and functioning. RESULTS: NAC treatment caused a significant improvement on the MADRS (least squares mean difference [95% confidence interval]: -8.05 [-13.16, -2.95], p = .002) and most secondary scales at end point. Benefit was evident by 8 weeks on the Global Assessment of Functioning Scale and Social and Occupational Functioning Assessment Scale and at 20 weeks on the MADRS. Improvements were lost after washout. There was no effect of NAC on time to a mood episode (log-rank test: p = .96 and no significant between-group differences in adverse events. Effect sizes at end point were medium to high for improvements in MADRS and 9 of the 12 secondary readouts. CONCLUSIONS: NAC appears a safe and effective augmentation strategy for depressive symptoms in bipolar disorder.
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Nail-biting stuff? The effect of N-acetyl cysteine on nail-biting.
Berk M, Jeavons S, Dean OM, Dodd S, Moss K, Gama CS, Malhi GS.

Department of Clinical and Biomedical Sciences, University of Melbourne, Australia. mikebe@barwonhealth.org.au
N-acetyl cysteine (NAC) is a widely available nutraceutical with a variety of actions. As a precursor of cysteine and glutathione, it has antioxidant properties that may impact on mood and contribute to an effect on impulsivity and obsessive behaviour. Via its additional effect on glutamate via the cystine-glutamate exchange system, NAC has been shown to mediate impulsivity in preclinical models of addiction, reduce craving, and cue extinction. Further, by boosting glutathione, NAC acts as a potent antioxidant and has been shown in two positive, large-scale randomized placebo-controlled trials to affect negative symptoms in schizophrenia and depression in bipolar disorder. We describe three cases in which its actions specifically on nail-biting and associated anxiety may offer a potential treatment. The spontaneous findings are reported as part of an ongoing treatment trial examining the utility of NAC in bipolar disorder. Its actions, if robustly replicated, also point to potential treatment targets in glutathione or glutamate pathways in the brain.
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N-acetylcysteine, a glutamate modulator, in the treatment of trichotillomania: a double-blind, placebo-controlled study.
This study, the first to our knowledge that examines the efficacy of a glutamatergic agent in the treatment of trichotillomania, found that N-acetylcysteine demonstrated statistically significant reductions in trichotillomania [obsessive hair pulling] symptoms. No adverse events occurred in the N-acetylcysteine group, and N-acetylcysteine was well tolerated.
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Old 10-16-2009, 05:52 PM   #2 (permalink)
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Pardon my ignorance, but what is Nac.

btw - nice avatar
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Old 10-16-2009, 07:46 PM   #3 (permalink)
 
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NAC is great but unfortunately, doses higher than 500 mg per day can cause pulmonary hypertension. I lowered my dose to 500 daily. This was done in a mouse study though, so I wonder how it translates to humans.
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Old 10-17-2009, 02:15 AM   #4 (permalink)
 
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Originally Posted by jer View Post
Pardon my ignorance, but what is Nac.

btw - nice avatar
http://en.wikipedia.org/wiki/Acetylcysteine

I got it from my pharmacy.
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Old 10-17-2009, 08:20 AM   #5 (permalink)
 
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Originally Posted by Beggiatoa View Post
NAC is great but unfortunately, doses higher than 500 mg per day can cause pulmonary hypertension. I lowered my dose to 500 daily. This was done in a mouse study though, so I wonder how it translates to humans.
Have you got some information about that?
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Old 10-17-2009, 11:04 PM   #6 (permalink)
 
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hey that's awesome.

i've been thinking about giving the natural route a shot, and have started on NAC in anticipation of ending my Parnate trial.

i've been using 1200mg a day for about a week. the weird thing is i got quite sick when i first began taking it, which i think must be a positive sign that something's happening detoxification-wise. otherwise, i can't say i've noticed any huge gains OCD-wise just yet. how long have you been using it, and how bad's your OCD if you don't mind me asking? mine's rather severe, so i don't have a tonne of hope, but no harm in trying i guess.

btw, that study with mice used massive doses, and is the only study of it's kind that i know of; contrarily, there are kajillions of studies reporting NAC's safety as an antioxidant. just don't take it too close to exercising, or it might nullify the benefits.
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Old 10-18-2009, 04:43 AM   #7 (permalink)
 
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Originally Posted by odspot View Post
hey that's awesome.

i've been thinking about giving the natural route a shot, and have started on NAC in anticipation of ending my Parnate trial.

i've been using 1200mg a day for about a week. the weird thing is i got quite sick when i first began taking it, which i think must be a positive sign that something's happening detoxification-wise. otherwise, i can't say i've noticed any huge gains OCD-wise just yet. how long have you been using it, and how bad's your OCD if you don't mind me asking? mine's rather severe, so i don't have a tonne of hope, but no harm in trying i guess.

btw, that study with mice used massive doses, and is the only study of it's kind that i know of; contrarily, there are kajillions of studies reporting NAC's safety as an antioxidant. just don't take it too close to exercising, or it might nullify the benefits.
I agree, there are loads of positive studies.

My ocd is pretty bad yes, and its going in attack when i'm trying to eat healthy or take supplements. (becaue i think i need to be in a good mood and dont have any stress when starting to take them, or they may not work...)

Nac took the edge off that.

It also made me sick when i started taking it.

as for social anxiety i dont think there any natural treatment that will work for it, only for OCD, NAC and Inositol have shown to be effective.

I suggest you not to stop taking medication for your anxiety tough.
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Old 10-18-2009, 04:41 PM   #8 (permalink)
 
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oh, i wasn't going to stop the medication just so i can take NAC. i was only trialling Parnate, but it's not really working out, so i wanted to see if some natural stuff helped since i've tried a tonne of meds and none have helped (without causing unpleasant side-effects anyway).

yeah i never got majorly sick - just some flu kind of symptoms - sore throat etc. i'll try raising it to 600mg x3 times a day. my OCD symptoms are a lot worse than my social anxiety, so i'm trying to help the OCD first.

did you ever try inositol ?
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Old 10-19-2009, 02:28 AM   #9 (permalink)
 
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Originally Posted by odspot View Post
oh, i wasn't going to stop the medication just so i can take NAC. i was only trialling Parnate, but it's not really working out, so i wanted to see if some natural stuff helped since i've tried a tonne of meds and none have helped (without causing unpleasant side-effects anyway).

yeah i never got majorly sick - just some flu kind of symptoms - sore throat etc. i'll try raising it to 600mg x3 times a day. my OCD symptoms are a lot worse than my social anxiety, so i'm trying to help the OCD first.

did you ever try inositol ?
Yes, but it gives you bad cramps so you have to slowly up the dose, stopped taking it but i'l propebly gonna take it again.
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Old 10-19-2009, 05:05 PM   #10 (permalink)
 
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Hi CrazyMed, I too suffer from moderate OCD and have been reading some promising research on NAC. It is fantastic to here that it is working for you.

Pittinger and a group at Yale are currently doing clinical trials using NAC and other glutamate antagonists. This research offers great hope to us of a new generation of treatments with a better side effect profile than SSRIs.

The PAH research associated with NA has spooked me somewhat though, although from what I gather the dose that the mice were receiving in the Palmer 2007 paper was around 40-fold higher dose per weight than the Hildebrandt 2001 paper where humans were given 600mg day. So by a rough calculation, if you can believe the rather obscure details given by the authors, an equivalent human dose would be about roughly 24grams a day, depending on body weight etc. But don't take this as gospel, by my own calculation a 20gram mouse drivinking 5Ml of water per day at 10mg/ml NAC this is 50mg/day which is a dose of 2.5g/Kg which would be this equivalent of 200g/day for an 80kg human. In any case the mice were receiving far more than the 3g/day used in most NAC trials for OCD.

This research has put me off using as much as I originally intended (3g/day) but I have recently ordered 1/2 kilo of NAC and intend to start using it around 1/g/day.

PS I too have found inositol to helpful, I have used it for a couple of months at 10-12 grams/day and found a very noticeable antidepressant effect, and the ability to dissengage from compulsions more easily, it hasn't been the magic bullet but has definitely eased my distress.

I will provide an update once I have commenced NAC.
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Old 10-19-2009, 09:50 PM   #11 (permalink)
 
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i'm taking 1.2g now a day and am fairly certain it's helping. i also raised my Parnate dose to 40mg, but the sleep deprivation caused by MAOI's is so severe that it usually worsens my OCD at first (at least that was my experience when i trialled Nardil at the beginning of the year).

even on 30mg of Parnate i found myself ruminating often throughout the day, so i'm convinced it's the NAC which has caused the improvement in my OCD over the past week.

my only concern is what effect regulating glutamate might have overall. i am not too familiar with NAC's mechanism, but i tried Memantine (a partial NMDA agonist) as monotherapy before i was put onto Parnate, and it caused the worst flat/anhedonic/dissociative/brain-foggy feeling, i guess by pretty much locking down glutamate.

i'll also try keeping my NAC dose to ~1g for now. soto did you notice any foggy feelings on inositol? the first time i tried it (about 2g a day) i felt kinda dizzy and foggy so got scared off. sometimes that reaction is good (b12 did the same thing at first, and my levels turned out to be really low), so i wanna give it a proper trial; i've ordered it in bulk so i can try 10+g a day.
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Old 10-19-2009, 10:48 PM   #12 (permalink)
 
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Hi OdSpot - I don't think memantine is meant to work very well with OCD, riluzole and NAC have been found to be more effective according to this research: Glutamate-Modulating Drugs as Novel Pharmacotherapeutic Agents in the Treatment of Obsessive-Compulsive Disorder
NeuroRX, Volume 3, Issue 1, 2006, Pages 69-81
C. Pittenger, J. Krystal, V. Coric. In a nutshell these drugs inhibit the presynaptic release of glutamate, which has been shown to be hyperactive with OCD in the brain circuits between the caudate nucleus and orbitonfrontal cortex - they decrease this activity.

With Inositol I started on about 5g a day for the first week, then dosed up to 10-12g (I take 2 teaspoons in the morning and 2 before dinner - so I am not sure of the exact dose). Yeah, it's much cheaper to buy in bulk I think I paid about $100 for a kg - and I have heard it is absorbed alot better as powder than in capsules. In the first couple of weeks I noticed a number of mild side-effects like tiredness and decrease in libido (however nothing as extreme as SRIs). Since then these side effects have pretty much gone away - the only noticeable effect is that I am still having a lot more vivid dreams than usual, and mild GI upset. If I have 2 teaspoons on an empty stomach it is quite strong, ...yeah I have noticed a little bit of the foggy feeling at times - this is the reason I have not increased the dose any higher to 18g like some studies suggest. I think everyone's body is different, but for me 12g seems to work quite well.

hope this helps
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Old 10-20-2009, 12:02 AM   #13 (permalink)
 
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hey soto, that's interesting; there's quite a few studies showing Memantine as an effective add-on treatment for refractory OCD. the key i think is using it in conjunction with an SSRI; as monotherapy, it isn't all that useful.

yeah i never gave inositol more than a few days the couple of times i tried it. i did think i was getting tired, and noticed my libido was worse, but i thought that was all in my head, so it's good to know the side-effects are real and also pass eventually! i work as a writer and could never tolerate SSRI's because they numb my creativity. i noticed though that inositol seemed really helpful when withdrawing off drugs, and sometimes when i had a mental block, inositol seemed to help get the thoughts flowing.

i haven't written since i became depressed, and am hoping to get back into it. if Parnate doesn't work out, i'll give inositol a proper trial, given the promising results i saw in the past. i also start CBT again this week, which should help the OCD.
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Old 10-23-2009, 12:32 PM   #14 (permalink)
 
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thats funny i was just about to go buy some NAC...im on Parnate,,...and its making my OCD worse...i have moderate OCD. but if i let it, it gets out of control.....i don't know of too many good NMDA antagonists besides DXM, but that will kill me with Parnate.
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Old 10-23-2009, 12:33 PM   #15 (permalink)
 
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Originally Posted by Vini Vidi Vici View Post
thats funny i was just about to go buy some NAC...im on Parnate,,...and its making my OCD worse...i have moderate OCD. but if i let it, it gets out of control.....i don't know of too many good NMDA antagonists besides DXM, but that will kill me with Parnate.
Memantine is an excellent NMDA antagonis
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Old 10-23-2009, 02:45 PM   #16 (permalink)
 
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Originally Posted by crayzyMed View Post
I only knew NAC as something you use for tylenol overdose and as a mucolytic. But surprise, surprise, there are a ton of uses for it (in the investigational stage, admittedly).

"The following uses have not been well-established or investigated:

  1. NAC has been shown to reduce the symptoms of both schizophrenia[15] and bipolar disorder[16] in two placebo controlled trials.
  2. Evidence that NAC and other antioxidants can exert beneficial effects on pancreatic b-cell function in diabetes was published in a 1999 study. The authors conclude that a sufficient supply of antioxidants (NAC, vitamin C plus vitamin E, or both) may prevent or delay b-cell dysfunction in diabetes by providing protection against glucose toxicity.[17]
  3. NAC is undergoing clinical trials in the United States for the treatment of obsessive-compulsive disorder.[18] It is thought to counteract the glutamate hyperactivity in OCD.
  4. NAC has been shown to reduce cravings associated with chronic cocaine use in a study conducted at the Medical University of South Carolina[19][20]
  5. It may reduce the incidence of chronic obstructive pulmonary disease (COPD) exacerbations[21]
  6. In the treatment of AIDS, NAC has been shown to cause a "marked increase in immunological functions and plasma albumin concentrations"[22] Albumin concentration are inversely correlated with muscle wasting (cachexia), a condition associated with AIDS.
  7. An animal study indicates that acetylcysteine may decrease mortality associated with influenza [23]
  8. Animal studies suggest that NAC may help prevent noise-induced hearing loss. [24] A clinical trial to determine efficacy in preventing noise-induced sensorineural hearing loss in humans is currently (2006) being jointly conducted by the US Army and US Navy.[citation needed]
  9. A human study of 262 primarily elderly individuals indicates that NAC may decrease influenza symptoms. In the study, 25% of virus-infected subjects NAC treatment developed a symptoms, whereas 79% in the placebo group developed symptoms. [25]
  10. It has been suggested that NAC may help sufferers of Samter's triad by increasing levels of glutathione allowing faster breakdown of salicylates, though there is no evidence that it is of benefit [26]
  11. There are claims that acetylcysteine taken together with vitamin C and B1 can be used to prevent and relieve symptoms of veisalgia (hangover following ethanol (alcohol) consumption). The claimed mechanism is through scavenging of acetaldehyde, a toxic intermediate in the metabolism of ethanol.[27][28]
  12. It has been shown to help women with PCOS (polycystic ovary syndrome) to reduce insulin problems and possibly improve fertility. [29]
  13. Small studies have shown acetylcysteine to be of benefit to sufferers of blepharitis[citation needed] and has been shown to reduce ocular soreness caused by Sjogren's syndrome.[citation needed]
  14. Studies in mice models of Ataxia Telangictasia (ATM knockout) indicate that NAC prevents genomic instability and retards lymphomagenesis in these animals.[citation needed] Clinical trials in human AT patients are underway.[citation needed]
  15. It has been shown to help trichotillomania[30], a condition causing compulsive hair-pulling.
  16. It has been shown to help methylmercury poisoning[31]
  17. It has been shown effective in Unverricht-Lundborg disease in an open trial in 4 patients. A marked decrease in myoclonus and some normalization of somatosensory evoked potentials with N -acetylcysteine treatment has been documented. http://emedicine.medscape.com/article/1153370-overview


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Old 10-23-2009, 03:16 PM   #17 (permalink)
 
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Its one of those multiuse supplements, resveratrol is another one that i think may have alot more uses then discovered.
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Old 10-24-2009, 01:54 PM   #18 (permalink)
 
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in general, how sick did it make you when you started taking it, anybody? i mean i don't wanna get sick again like cuz i just had the flu and everything. is it worth taking for OCD with the side effects and all
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Old 10-24-2009, 02:05 PM   #19 (permalink)
 
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Quote:
Originally Posted by Vini Vidi Vici View Post
in general, how sick did it make you when you started taking it, anybody? i mean i don't wanna get sick again like cuz i just had the flu and everything. is it worth taking for OCD with the side effects and all
Its nothing to worry about, not bad at all
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Old 10-24-2009, 02:38 PM   #20 (permalink)
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Hi, you guys taking NAC, I would like to give it a try. My OCD is severe.

I would appreciate if you could tell me the brands are you taking and where do you get them.
Is there a recommended "best" brand that I need to look for.
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