Acetyl-L-Carnitine in Attention-Deficit/Hyperactivity Disorder: A Multi-Site, Placebo-Controlled Pilot Trial
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Date
2007
Journal Title
Journal ISSN
Volume Title
Publisher
Mary Ann Liebert, Inc. Publishers
Abstract
Objective:
To determine whether acetyl-L-carnitine (ALC), a metabolite necessary for energy metabolism and
essential fatty acid anabolism, might help attention-deficit/hyperactivity disorder (ADHD). Trials in Down’s
syndrome, migraine, and Alzheimer’s disease showed benefit for attention. A preliminary trial in ADHD
using L-carnitine reported significant benefit.
Method:
A multi-site 16-week pilot study randomized 112 children (83 boys, 29 girls) age 5-12 with
systematically diagnosed ADHD to placebo or ALC in weight-based doses from 500 to 1500 mg b.i.d. The
2001 revisions of the Conners’ parent and teacher scales (including DSM-IV ADHD symptoms) were
administered at baseline, 8, 12, and 16 weeks. Analyses were ANOVA of change from baseline to 16 weeks
with treatment, center, and treatment-by-center interaction as independent variables.
Results:
The primary intent-to-treat analysis, of 9 DSM-IV teacher-rated inattentive symptoms, was not
significant. However, secondary analyses were interesting. There was significant (p = 0.02) moderation by
subtype: superiority of ALC over placebo in the inattentive type, with an opposite tendency in combined
type. There was also a geographic effect (p = 0.047). Side effects were negligible; electrocardiograms, lab
work, and physical exam unremarkable.
Conclusion:
ALC appears safe, but with no effect on the overall ADHD population (especially combined type).
It deserves further exploration for possible benefit specifically in the inattentive type.
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Citation
L. Eugene Arnold et al, "Acetyl-L-Carnitine in Attention-Deficit/Hyperactivity Disorder: A Multi-Site, Placebo-Controlled Pilot Trial," Journal of Child and Adolescent Psychopharmacology 17, no. 6 (2007), doi:10.1089/cap.2007.018