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Uncontrolled RA with active inflammation affects joint remodeling leading to degradation of cartilage, proliferation of synoviocytes, reduced bone mineralization and enhanced differentiation of macrophages into osteoclasts

One clinical trial enrolled 73 eligible participants with normal but low B12 levels and inadequate initial response to selective serotonin reuptake inhibitors (SSRIs), who were randomly assigned to either a treatment group (antidepressants combined with B12 injections, n = 34) or a control group (antidepressants alone, n = 39)

Not soluble in bacteriostatic water alone

Notably, treatment with NAC reinstated system xCT activity, normalized glutamate concentrations, and ameliorated behavioral deficits, such as impaired prepulse inhibition and social interactions [77]

10.1016/j.phrs.2016.01.001 2 ByunS

Benichou, T