A review of current evidence for acetyl-l-carnitine in the treatment of depression
Abstract
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.
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Four separate RCTs suggested the efficacy of acetyl-L-carnitine over placebo in mitigating depressive symptoms in major depressive disorder.
“Four separate RCTs suggested the efficacy of ALC over a placebo in mitigating depressive symptoms in MDD [128].”
From Cognitive remission: a novel objective for the treatment of major depression? (2016) · cites this paper as [128]
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- Authors
- Wang, S.-M., Han, C., Lee, S.-J., Patkar, A. A., Masand, P. S., & Pae, C.-U.
- Affiliations
- Catholic University of Korea (KR)
- Korea University (KR)
- Duke Medical Center (US)
- Duke University (US)
- Corresponding author
- Pae, Chi-Un
- Venue
- Journal of Psychiatric Research
- Publisher
- Elsevier BV
- Published
- 2014-06
- Volume
- 53
- Pages
- 30-37
- ISSN
- 0022-3956 (ISSN-L)
- OpenAlex
- W2001856276
- Cited by
- 110
- References
- 76
- Citations by year
- 2026: 3 · 2025: 11 · 2024: 9 · 2023: 6 · 2022: 9 · 2021: 10 · 2020: 9 · 2019: 8 · 2018: 11 · 2017: 11 · 2016: 10 · 2015: 11 · 2014: 2
- FWCI
- 1.45
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Psychiatric Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Ministry of Health and Welfare (A120004)
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Disorders
- Keywords
- acetyl-L-carnitine, depression, dysthymia, fibromyalgia, minimal hepatic encephalopathy, neuroplasticity, antidepressant efficacy, drug tolerability, fluoxetine, amisulpride, comorbidities, older adults
- MeSH terms
- Acetylcarnitine, Depression, Humans, ROC Curve, Vitamin B Complex
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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