{"doi":"10.1111/acer.15402","title":"Effect of <i>N</i>‐acetylcysteine on neural alcohol cue reactivity and craving in adolescents who drink heavily: A preliminary randomized clinical trial","abstract":"Abstract Background Alcohol craving is related to problematic alcohol use; therefore, pharmacotherapies that modulate alcohol craving are of interest. N ‐acetylcysteine, an over‐the‐counter antioxidant, is a candidate pharmacotherapy for adolescent alcohol use with the potential to impact craving. Cue‐reactivity paradigms using functional magnetic resonance imaging (fMRI) can identify neural regions implicated in craving and serve as a screening tool for novel pharmacotherapy options. Methods This preliminary study examined the effect of N ‐acetylcysteine on neural reactivity to alcohol cues and subjective craving among 31 non‐treatment‐seeking adolescents (17.6–19.9 years old, 55% female) who use alcohol heavily. In a randomized cross‐over design, participants completed three fMRI sessions: baseline and after a 10‐day course of N ‐acetylcysteine (1200 mg twice daily) and matched placebo. The primary outcome was neural response to alcohol versus non‐alcohol beverage cues after N ‐acetylcysteine versus placebo, with a secondary outcome of self‐reported subjective craving. Results In the full sample ( n = 31), there was no effect of N ‐acetylcysteine versus placebo on neural alcohol reactivity ( p s ≥ 0.49; s = 0.00–0.07) or self‐reported acute alcohol craving ( p = 0.18, = 0.06). However, N ‐acetylcysteine did reduce self‐reported generalized alcohol craving ( p = 0.03, = 0.15). In a subsample of youth who met criteria for past‐year alcohol use disorder ( n = 19), results remained unchanged. Conclusions N ‐acetylcysteine may not alter neural reactivity to alcohol cues or acute craving; however, it may reduce general subjective alcohol craving among adolescents who consume alcohol heavily.","journal":"Alcohol Clinical and Experimental Research","year":2024,"id":468463,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":3,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9496,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":657170,"name":"Anna E. Kirkland","orcid":"0000-0001-5308-2423","position":1,"is_corresponding":false},{"id":397948,"name":"Brittney D. Browning","orcid":"0000-0002-9868-0440","position":2,"is_corresponding":false},{"id":404562,"name":"Pamela L. Ferguson","orcid":"0000-0002-4210-2625","position":3,"is_corresponding":false},{"id":350609,"name":"Kevin M. Gray","orcid":"0000-0003-4503-7395","position":4,"is_corresponding":false},{"id":268689,"name":"Lindsay M. Squeglia","orcid":"0000-0001-5994-6894","position":5,"is_corresponding":false},{"id":885935,"name":"ReJoyce Green","orcid":"0000-0003-1892-0289","position":0,"is_corresponding":true}],"reference_count":65,"raw_metadata":null,"created_at":"2026-07-19T02:05:23.500722Z","pmid":"38960894","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}