A review of current evidence for acetyl-l-carnitine in the treatment of depression.

Published

Journal Article (Review)

Despite numerous antidepressants available, many patients with depression do not achieve adequate response rendering needs for novel antidepressants with different mechanism of actions. Acetyl-l-carnitine (ALC) is a potential antidepressant with novel mechanism of action because of its diverse functions related with neuroplasticity. Animal and cellular models suggest that ALC's neuroplasiticity effect, membrane modulation, and neurotransmitter regulation may play an important role in treatment of depression. Four randomized clinical studies (RCT) demonstrated the superior efficacy of ALC over placebo (PBO) in patients with depression. Two RCTs showed its superior efficacy over PBO in dysthymic disorder, and 2 other RCTs showed that it is equally effective as fluoxetine and amisulpride in treatment of dysthymic disorder. ALC was also effective in improving depressive symptoms in patients with fibromyalgia and minimal hepatic encephalopathy. It was also found to be equally tolerable to PBO and better tolerable than fluoxetine and amisulpride. In conclusion, ALC may be potentially effective and tolerable next treatment option with novel action mechanisms for patients with depression, in particular older population and patients with comorbid medical conditions who are vulnerable to adverse events from antidepressants. However, more clinical trial data with adequately-powered, well-designed and advanced methodology will be mandatory to conclude whether ALC as a monotherapy or augmentation agent may be efficacious and clinically beneficial for depression.

Full Text

Duke Authors

Cited Authors

  • Wang, S-M; Han, C; Lee, S-J; Patkar, AA; Masand, PS; Pae, C-U

Published Date

  • June 2014

Published In

Volume / Issue

  • 53 /

Start / End Page

  • 30 - 37

PubMed ID

  • 24607292

Pubmed Central ID

  • 24607292

Electronic International Standard Serial Number (EISSN)

  • 1879-1379

Digital Object Identifier (DOI)

  • 10.1016/j.jpsychires.2014.02.005

Language

  • eng

Conference Location

  • England