Risks/Side Effects

The clinically most common side effects from n-acetylcysteine include nausea, indigestion, headache, and abdominal pain although it is generally well tolerated. Contraindications include current asthma and current pregnancy/lactation as the effects of NAC on fetal development has not been assessed.

The clinically most common side effects from SSRI medications include nausea, dry mouth, headache, diarrhea, nervousness, agitation or restlessness, reduced sexual desire or difficulty reaching orgasm, inability to maintain an erection (erectile dysfunction), rash, increased sweating, weight gain, drowsiness, or insomnia.

The most common adverse events resulting from naltrexone include nausea, sedation, vivid dreaming, and dizziness. Rarer but a more serious side effect of naltrexone may include elevated liver function tests (LFTs). If this occurs, the medication should be stopped and LFTs monitor until they return to baseline. Use of other the counter analgesics may increase the likelihood for elevated LFTs. Naltrexone should not be started in anyone who is taking opioid agonists.

Adolescent and young adult patients with excoriation and co-occurring Major Depressive Disorder or symptoms of depression who are taking antidepressant medications should be alerted to the risk of clinical worsening of depressive symptoms and suicidal ideation which have been linked to the use of these medications. Parents and guardians of children who are prescribed antidepressants, regardless of depression history, should be alerted to this risk.

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