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NAC's primary metabolism occurs through non-CYP450 pathways (tissue uptake and acetylation), so the CYP450 interaction concern that exists with some prescription medications does not apply to NAC at supplement doses

Generalized anxiety disorder (GAD) and comorbid major depression with GAD are characterized by enhanced nitro-oxidative stress, increased lipid peroxidation, and lowered lipid-associated antioxidant defenses

At this point, we have previously shown that IGF-I is a main character in restoring mitochondrial dysfunction during aging by increasing mitochondrial membrane potential, reducing oxygen consumption, and increasing ATP synthesis what in turn minimize the c-cytochrome release to the cytoplasm and subsequently promote neural survival by decreasing caspase-induced apoptosis[55, 56], in agreement with in vitro reported works from others[242244]

This is the second piece of the puzzle

The prescribing information notes that gastrointestinal adverse effects are the most common reasons for treatment discontinuation