In hindsight, it's obvious how a perfectly great supplement—N-acetylcysteine (NAC)—can cause a bad reaction. Part of pioneering better and safer approaches for medication withdrawal is learning how to do it, well, better. As I improve, I hope that you'll be able to learn vicariously through my experiences and be all the wiser for it.
My clinical experiences using NAC have definitely clarified the cause-and-effect relationship between detoxification, medication withdrawal, and mental health.
Read on for a brief summary of these important topics!
What Negative Reactions to N-Acetylcysteine (NAC) Can Teach Us About Withdrawal
And how to handle it!
Allegory of Plato’s Cave
For over a decade, I used Liver Extract to help my patients improve their liver function with good results. Unfortunately, Ecological Formulas/Cardiovascular Research stopped making it this year. I didn't have a similar product to replace it with because other liver extracts didn't test well with my patients. So, I went searching for a substitute.
An herbalist that I met in Utah was using NAC for his clients to decrease mucus. Our conversation at his store reminded me that I used NAC a long time ago for detoxification because NAC increases the production of glutathione. So, on my return from Utah, I decided to put some of my patients on it, to help them with detoxification and support their liver function. That's when things went south for them.
Before you think of this amazing supplement as a "bad" supplement, I want to share an article on the many positive benefits of NAC for psychiatric disorders: N-acetylcysteine in psychiatry: current therapeutic evidence and potential mechanisms of action (March 2011).
So, why would a helpful supplement cause patients to feel worse?
The answer, I believe, is because NAC powerfully detoxified my patients' medications. The body metabolizes medications and drugs as foreign substances and treats them as toxins. Glutathione is central to that process. When my patients took NAC, their glutathione levels went up, and medication levels went down, i.e. everyone suddenly experienced medication withdrawal and "relapsed." (And I learned, the hard way, that my old, tried-and-true Liver Extract and NAC did not have equivalent clinical results.)
Though the symptoms feel indistinguishable to the patient, they are not due to the same process. The original symptoms likely had multiple underlying causes and will improve with the use of NAC. Once a patient gets on psychiatric medications, however, NAC will likely cause a recurrence of those symptoms by undermining the beneficial neurotransmitter effects of psychiatric medications.
For example, a person may feel unhappy because he lost his job. He starts using Prozac and stops feeling unhappy. However, when he goes into withdrawal because he runs out of Prozac, he feels unhappy again. Now he has two problems: he's unhappy about losing his job and from being in withdrawal. The two causes are not the same, but they both feel the same.
If patients come to my office without having started medications, and I start them on NAC, they will not experience medication withdrawal. Instead, they will experience a strong detoxification effect from increased glutathione levels that support both the liver and the immune system. The detoxification would result in lowered toxicity levels, improved enzyme function, and overall improvement.
For patients on medications, however, generalized detoxification will make them feel worse because they will experience sudden withdrawal symptoms. I have seen this happen in the past and never clearly connected the dots until now.
This is one of the main consequences of being on medication: detoxification becomes easily enmeshed with withdrawal and patients are put in a difficult situation where they have to choose between functioning on "toxic" medications or suffering a painful path to true wellness. This is a powerful reason why using a natural approach first, before starting any medications, can lead to a more straight forward and complete recovery.
If you are a psychiatrist dealing with a patient whose medications have "stopped working," it will be important to find out whether detoxification had caused the relapse. If so, what would restabilize the patient? I would stop their NAC or other powerful detoxifier and increase their medication and supplements to support their sudden withdrawal symptoms.
This is exactly what I did for my patients. Symptoms resolved and they restabilized in about a week, demonstrating to me the clear connection between detoxification, medication withdrawal, and symptoms that mimic the original mental illness.
Hope these insights help!