The Barwon Psychiatric Research Unit and the Mental Health Research Institute
are collaborating to investigate oxidative stress and psychiatric illnesses.

At present, clinical trials investigating antioxidant treatments for psychiatric illnesses are being undertaken, as well as partnerships on laboratory-based projects aimed at
clarifying the underlying mechanisms.

The Barwon Psychiatric Research Unit encompasses a broad range of psychiatric research. These include epidemiology studies looking primarily at prevention of psychiatric disorders, diet, and the psychological somatic interface. There is an active clinical trials unit, focusing on oxidative biology and internet-based therapies. Drug safety is a further focus. The unit aims to further understand the underlying pathology of mental illness and to assist in the discovery of better treatments for people with these illnesses.

The team has published many papers and received several awards, including the Australasian Society of Psychiatric Research Eli Lilly Oration, the Pathcare
Smart Geelong Research and Learning Expo Health and Lifestyle Award and the G Force Recruitment Researcher of the Year Award for this work.

Antioxidant trials

These trials are investigating the benefits of the antioxidant N-acetyl cysteine (NAC) on the symptoms of psychiatric illness. A clinical trial investigating antioxidant treatments and bipolar disorder has been completed with two additional trials underway.

One is investigating bipolar disorder using a larger trial with an alternative design and has recruited a total of 155 participants. The second is investigating depression
and continues to recruit participants.

Two major publications have resulted from earlier trials investigating NAC as an adjunct therapy in schizophrenia and bipolar disorder. These showed that NAC (in addition to participants’ usual treatment) was beneficial over placebo in treating the symptoms of these illnesses.

In conjunction with these trials, magnetic resonance spectroscopy is being used to investigate biochemical markers following NAC treatment. The unit has also
formed a collaboration with Brian Dean (from the Rebecca L Cooper Laboratory) and a team in Canada to investigate oxidative markers in postmortem brain tissue.

NAC in bipolar disorder

This clinical trial is investigating the benefits of NAC in treating the depressive phase of bipolar disorder. The trial is a maintenance-designed trial where all participants are given NAC for two months.

Following this, participants are randomised into either continuing NAC treatment or receiving a placebo. Participants continue on the trial for a further six months and
interviews are conducted regularly to assess the changes in participant’s symptoms. The trial of NAC is being conducted in addition to the usual treatment participants are undergoing. Recruitment for this study has been completed and there are 31 participants currently participating in the trial.

NAC in major depression

This clinical trial is using a double blind, randomised design to investigate the benefits of NAC treatment compared with placebo in people with unipolar (major) depression. As with the bipolar disorder trial, participants are maintained on their usual treatment and given either NAC or placebo in addition to that. Participants are asked to take trial medication for three months. Over this period, participants are interviewed several times to determine changes in their symptoms. Four weeks following the end of the trial medication, a follow-up visit is conducted to establish how participants’ symptoms have changed following the discontinuation of NAC. The recruitment target for this trial is 120 participants, of which 98 have been recruited to date.

Funding

The Stanley Medical Research Institute has provided a research grant to undertake the NAC in bipolar disorder trial. A grant has also been provided from the Rotary
Foundation to assist in the funding of the depression trial.

Future directions

The unit is developing trials of the use of NAC in smoking cessation, and is examining trials in early intervention in psychosis. In addition, a series of projects examining the
biological foundation of the activity of NAC are planned.