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Methadone + N-acetyl cysteine is a combination of two small molecule drugs. Methadone is a synthetic opioid agonist primarily used for opioid dependence and pain management, acting mainly on the mu-opioid receptor to reduce withdrawal symptoms and cravings in patients with opioid use disorder. N-acetyl cysteine (NAC) is an antioxidant and glutamatergic modulator that increases extracellular glutamate levels, restores redox balance, and has been investigated for its potential to improve neuropsychiatric symptoms, metabolic profiles, and reduce craving or relapse risk in substance use disorders. The combination has been studied as an adjunct therapy in methadone maintenance treatment (MMT) for substance use disorder to address psychological complications (such as depression and anxiety), metabolic disturbances, oxidative stress markers, as well as in acute methadone poisoning scenarios where NAC may provide additional hepatic protection or symptom improvement[1][3][5].
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