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Bipolar disorder: A landmark RCT (n=75) found that NAC (1,000 mg twice daily for 24 weeks) produced a significant improvement in depression scores (Montgomery-Asberg Depression Rating Scale) in bipolar disorder as an adjunct to usual treatment (Berk et al., Biol Psychiatry, 2008) [74]

Furthermore, excess NAC not used for GSH synthesis is converted to Krebs cycle intermediates and supports mitochondrial bioenergetics leading to higher ATP levels in hepatocytes [69] (Fig