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Altered glutamate levels, may contribute to the development and persistence of OCD symptoms ( NAC, which has emerged as a particularly intriguing candidate, is a derivative of the amino acid cysteine, and has powerful antioxidant properties ( Given the evolving body of evidence regarding the use of NAC in the treatment of moderate to severe OCD, this systematic review and meta-analysis aims to comprehensively evaluate the literature, focusing on the safety and efficacy of NAC as an augmentation in the management of moderate to severe OCD