Acetyl-L-carnitine in attention-deficit/hyperactivity disorder: A multi-site, placebo-controlled pilot trial

作者：Arnold L Eugene^*; Amato Antonino; Bozzolo Hernan; Hollway Jill; Cook Amy; Ramadan Yaser; Crowl Lindsay; Zhang Dan; Thompson Susan; Testa Giussepe; Kliewer Vernon; Wigal Timothy; McBurnett Keith; Manos Michael

来源：Journal of Child and Adolescent Psychopharmacology, 2007, 17(6): 791-801.

DOI：10.1089/cap.2007.018

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.

• 出版日期2007-12
• 单位上海市精神卫生中心