Acetyl-L-carnitine reduces depression and improves quality of life in patients with minimal hepatic encephalopathy.

Abstract

BACKGROUND:

Minimal hepatic encephalopathy (MHE) represents a common complication present in well-compensated cirrhotic patients that impairs patients' daily functioning and health-related quality of life (HRQL). Acetyl-L-carnitine (ALC) has been shown to be useful in improving blood ammonia and cognitive functions in cirrhotic patients with MHE.

OBJECTIVE:

This study evaluated the effects of ALC treatment on HRQL and depression in patients with MHE.

STUDY DESIGN:

This was a randomized, double-blind, placebo-controlled study. Sixty-seven patients with MHE were recruited to the study. They were randomly assigned to two groups and received either 2 g acetyl-L-carnitine twice a day (n = 33) or placebo (n = 34) for 90 days. The primary efficacy measures were changes in aspartate aminotransferase, alanine aminotransferase, γ-glutamyl-transpeptidase, albumin, alkaline phosphatase, prothrombin time, and ammonia. Clinical and laboratory assessments, psychometric tests and automated electroencephalogram (EEG) analysis were performed for all patients.

RESULTS:

At the end of the study period, between the two groups, we observed a significant difference in physical function (p < 0.001), role physical (p < 0.001), general health (p < 0.001), social function (p < 0.05), role emotional (p < 0.05), mental health (p < 0.05), Beck Depression Inventory (p < 0.001), TMT-B s (p < 0.001), State Trait Inventory (p < 0.001), urea (p < 0.05), NH(4)(+) (p < 0.001), and bilirubin (p < 0.001).

CONCLUSIONS:

This study shows that ALC treatment is associated with significant improvement in patient energy levels, general functioning and well-being. The improvement of quality of life is associated with reduction of anxiety and depression.

• Authors: Mariano Malaguarnera, Rita Bella, Marco Vacante, Maria Giordano, Giulia Malaguarnera, Maria Pia Gargante, Massimo Motta, Antonio Mistretta, Liborio Rampello, Giovanni Pennisi
• Journal: Scandinavian journal of gastroenterology (Scand J Gastroenterol) Vol. 46 Issue 6 Pg. 750-9 (Jun 2011) ISSN: 1502-7708 [Electronic] England
• PMID: 21443422 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Nootropic Agents
• Acetylcarnitine

Topics

• Acetylcarnitine (therapeutic use)
• Adult
• Aged
• Anxiety Disorders (drug therapy)
• Depressive Disorder (drug therapy)
• Double-Blind Method
• Female
• Hepatic Encephalopathy (drug therapy)
• Humans
• Liver Function Tests
• Male
• Middle Aged
• Nootropic Agents (therapeutic use)
• Psychometrics
• Quality of Life (psychology)
• Treatment Outcome