This RCT compared omega-3 fatty acids plus inositol (O3I: 1020 mg EPA + 1000–2000 mg inositol) versus N-acetylcysteine (NAC: 1800–2700 mg/day) as open-label treatments over 6 weeks in children and adolescents aged 5–17 with emotional dysregulation, with or without autism traits (AT) defined by CBCL scores.
Both O3I and NAC produced modest improvements in depression and mania with no significant between-group difference overall. O3I showed statistically significant within-group improvement in depression (CDI); NAC showed a greater (but non-significant) decrease in mania (P-YMRS). In youth with AT, NAC outperformed O3I for mania and produced significant within-group improvements on SRS and BRIEF scores.
Open-label design introduces performance and detection bias. The 6-week duration is short for assessing sustained benefit. Sample size and power are not reported in the abstract, limiting interpretation of non-significant between-group comparisons.
For emotionally dysregulated youth aged 5–17, both O3I and NAC appear modestly beneficial; clinicians may favor NAC when autism traits and mania are prominent. Neither treatment showed a clear superiority overall, so either may be a reasonable first-line nutraceutical option pending larger blinded trials.
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