Exploratory Open Label, Randomized Study of Acetyl- and Propionylcarnitine in Chronic Fatigue Syndrome

Research Center Amsterdam, Amsterdam, Netherlands.
Psychosomatic Medicine (Impact Factor: 3.47). 03/2004; 66(2):276-82. DOI: 10.1097/01.psy.0000116249.60477.e9
Source: PubMed


We compared the effects of acetylcarnitine, propionylcarnitine and both compounds on the symptoms of chronic fatigue syndrome (CFS).
In an open, randomized fashion we compared 2 g/d acetyl-L-carnitine, 2 g/d propionyl-L-carnitine, and its combination in 3 groups of 30 CFS patients during 24 weeks. Effects were rated by clinical global impression of change. Secondary endpoints were the Multidimensional Fatigue Inventory, McGill Pain Questionnaire, and the Stroop attention concentration test. Scores were assessed 8 weeks before treatment; at randomization; after 8, 16, and 24 weeks of treatment; and 2 weeks later.
Clinical global impression of change after treatment showed considerable improvement in 59% of the patients in the acetylcarnitine group and 63% in the propionylcarnitine group, but less in the acetylcarnitine plus propionylcarnitine group (37%). Acetylcarnitine significantly improved mental fatigue (p =.015) and propionylcarnitine improved general fatigue (p =.004). Attention concentration improved in all groups, whereas pain complaints did not decrease in any group. Two weeks after treatment, worsening of fatigue was experienced by 52%, 50%, and 37% in the acetylcarnitine, propionylcarnitine, and combined group, respectively. In the acetylcarnitine group, but not in the other groups, the changes in plasma carnitine levels correlated with clinical improvement.
Acetylcarnitine and propionylcarnitine showed beneficial effect on fatigue and attention concentration. Less improvement was found by the combined treatment. Acetylcarnitine had main effect on mental fatigue and propionylcarnitine on general fatigue.

Download full-text


Available from: Hans Rudolf Scholte,
116 Reads
  • Source
    • "Acetylcarnitine and propionylcarnitine showed beneficial effects on muscular fatigue of dialysis. Acetylcarnitine had main effect on mental fatigue and propionylcarnitine on general fatigue [18] "
    [Show abstract] [Hide abstract]
    ABSTRACT: Skeletal muscle fatigue is a common symptom in various diseases, works and exercises. These were generally induced by neuron, metabolic conditions, overused muscle, and stress. But, there have been few principles about it. Many re-searchers have reported that acupuncture therapy has been useful to skeletal muscle fatigue on various diseases and conditions. However, it has never been shown why acupuncture therapy has the effect on skeletal muscle fatigue. The deficiency of carnitine induces fatigue, weakness, and disorder of skeletal muscle. It has showed that acupuncture in-duces the increase of carnitine in skeletal muscle. These findings demonstrated that acupuncture on skeletal muscle fa-tigue could increase carnitine as a possible affection mechanism.
    Chinese Medicine 01/2012; 03(01). DOI:10.4236/cm.2012.31003
  • Source
    • "A placebo procedure was employed in 16 trials [17-20,22-27,29-34]. Twenty of the included trials adopted a two-arm parallel group design [10-12,14,15,17-27,29,30,33,35], three adopted a three-arm parallel group design [16,28,34], and one used a four-arm parallel group design [13], while two trials employed a cross-over design [31,32]. Nine trials adopted the CDC criteria for the diagnosis of CFS [11,20,22,24,25,27,28,31,32], five studies diagnosed CFS according to the criteria published by Fukuda [10,15,16,19,21], five used the Oxford criteria [12,17,18,30,35], two combined with Fukuda and Oxford criteria [13,23], and one used a different classification system [33]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Throughout the world, patients with chronic diseases/illnesses use complementary and alternative medicines (CAM). The use of CAM is also substantial among patients with diseases/illnesses of unknown aetiology. Chronic fatigue syndrome (CFS), also termed myalgic encephalomyelitis (ME), is no exception. Hence, a systematic review of randomised controlled trials of CAM treatments in patients with CFS/ME was undertaken to summarise the existing evidence from RCTs of CAM treatments in this patient population. Seventeen data sources were searched up to 13th August 2011. All randomised controlled trials (RCTs) of any type of CAM therapy used for treating CFS were included, with the exception of acupuncture and complex herbal medicines; studies were included regardless of blinding. Controlled clinical trials, uncontrolled observational studies, and case studies were excluded. A total of 26 RCTs, which included 3,273 participants, met our inclusion criteria. The CAM therapy from the RCTs included the following: mind-body medicine, distant healing, massage, tuina and tai chi, homeopathy, ginseng, and dietary supplementation. Studies of qigong, massage and tuina were demonstrated to have positive effects, whereas distant healing failed to do so. Compared with placebo, homeopathy also had insufficient evidence of symptom improvement in CFS. Seventeen studies tested supplements for CFS. Most of the supplements failed to show beneficial effects for CFS, with the exception of NADH and magnesium. The results of our systematic review provide limited evidence for the effectiveness of CAM therapy in relieving symptoms of CFS. However, we are not able to draw firm conclusions concerning CAM therapy for CFS due to the limited number of RCTs for each therapy, the small sample size of each study and the high risk of bias in these trials. Further rigorous RCTs that focus on promising CAM therapies are warranted.
    BMC Complementary and Alternative Medicine 10/2011; 11(1):87. DOI:10.1186/1472-6882-11-87 · 2.02 Impact Factor
  • Source
    • "Worsening of fatigue after cessation of either or combined L-carnitines (Vermeulen and Scholte, 2004). "
    [Show abstract] [Hide abstract]
    ABSTRACT: For many years, a deficiency of monoamines including serotonin has been the prevailing hypothesis on depression, yet research has failed to confirm consistent relations between brain serotonin and depression. High degrees of overlapping comorbidities and common drug efficacies suggest that depression is one of a family of related conditions sometimes referred to as the "affective spectrum disorders", and variably including migraine, irritable bowel syndrome, chronic fatigue syndrome, fibromyalgia and generalized anxiety disorder, among many others. Herein, we present data from many different experimental modalities that strongly suggest components of mitochondrial dysfunction and inflammation in the pathogenesis of depression and other affective spectrum disorders. The three concepts of monoamines, energy metabolism and inflammatory pathways are inter-related in many complex manners. For example, the major categories of drugs used to treat depression have been demonstrated to exert effects on mitochondria and inflammation, as well as on monoamines. Furthermore, commonly-used mitochondrial-targeted treatments exert effects on mitochondria and inflammation, and are increasingly being shown to demonstrate efficacy in the affective spectrum disorders. We propose that interactions among monoamines, mitochondrial dysfunction and inflammation can inspire explanatory, rather than mere descriptive, models of these disorders.
    Progress in Neuro-Psychopharmacology and Biological Psychiatry 04/2011; 35(3):730-43. DOI:10.1016/j.pnpbp.2010.07.030 · 3.69 Impact Factor
Show more