N-acetylcysteine Versus Placebo for Treating Nail Biting, a Double Blind Randomized Placebo Controlled Clinical Trial

ISSN: 1875-614X (Online)
ISSN: 1871-5230 (Print)

Volume 15, 3 Issues, 2016

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Anti-Inflammatory & Anti-Allergy Agents in Medicinal Chemistry

Formerly: Current Medicinal Chemistry - Anti-Inflammatory and Anti-Allergy Agents

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Claudiu T. Supuran
Neurofarba Department
University of Florence

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N-acetylcysteine Versus Placebo for Treating Nail Biting, a Double Blind Randomized Placebo Controlled Clinical Trial

Anti-Inflammatory & Anti-Allergy Agents in Medicinal Chemistry, 12(3): 223-228.

Author(s): Ahmad Ghanizadeh, Nima Derakhshan and Michael Berk.

Affiliation: Research Center for Psychiatry and Behavioral Sciences, Department of Psychiatry, Hafez Hospital, Shiraz, Iran.


Nail biting is a common behavioral problem. While there are established behavioral interventions for management, they are of modest efficacy, and there is minimal evidence for effective pharmacotherapy. This study investigated the role of N-acetylcysteine (NAC) a potent glutathione and glutamate modulator for the treatment of pathological nail biting in children and adolescents. This pilot randomized, double-blind, placebo-controlled clinical trial of NAC (800mg/day) or placebo enrolled 42 children and adolescents with chronic nail biting. Nail length was the objective outcome. Evaluations were carried out three times; before treatment, one month after enrollment in the study, and two months after enrollment. The duration (chronicity) of nail biting in the NAC and placebo groups was 3.63(2.45) and 5.09(3.74) years (P=0.14). The mean nail length gradually increased in both the NAC and placebo groups during this trial. There was a statistically significant difference between the two groups regarding increased nail length after the first month of trial [(5.21(5.75) and 1.18(3.02) millimeters], however no difference after two months was observed. Two patients in the NAC group discontinued medication due to adverse events. One patient experienced headache, agitation, and social withdrawal, and another patient expressed severe aggression after taking medication and was withdrawn from the study. This study supports the hypothesis that NAC decreases nail biting behavior in children and adolescents over the short term. NAC is relatively well tolerated and severe adverse effects are rare. However, there was a high rate of dropout. Further studies with longer durations that build on these preliminary data are recommended. This study is registered at the Iranian Registry of Clinical Trials (Irct registration number: IRCT201103023930N3).


N-acetylcysteine, nail biting, children, obsessive compulsive, impulsive.

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Article Details

Volume: 12
Issue Number: 3
First Page: 223
Last Page: 228
Page Count: 6
DOI: 10.2174/1871523011312030003
Price: $58

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