L-Acetylcarnitine in dysthymic disorder in elderly patients: a double-blind, multicenter, controlled randomized study vs. fluoxetine

Eur Neuropsychopharmacol. 2013 Oct;23(10):1219-25. doi: 10.1016/j.euroneuro.2012.11.013. Epub 2013 Feb 18.


Introduction: L-Acetylcarnitine (LAC), the acetyl ester of carnitine naturally present in the central nervous system and involved in several neural pathways, has been demonstrated to be active in various animal experimental models resembling some features of human depression. The aim of the study is to verify whether LAC can have an antidepressant action in a population of elderly patients with dysthymic disorder in comparison with a traditional antidepressant such as fluoxetine.

Methods: Multicentric, double-blind, double-dummy, controlled, randomized study based on a observation period of 7 weeks. 80 patients with DSM-IV diagnosis of dysthymic disorder were enrolled in the study and subdivided into 2 groups. Group A patients received LAC plus placebo; group B patients received fluoxetine 20 mg/die plus placebo. Clinical assessment was performed through several psychometric scales at 6 different moments.

Results: Group A patients showed a statistically significant improvement in the following scales: HAM-D, HAM-A, BDI and Touluse Pieron Test. Comparison between the two groups, A and B, generally showed very similar clinical progression.

Discussion: The results obtained with LAC and fluoxetine were equivalent. As the subjects in this study were of senile age, it is possible to hypothesize that the LAC positive effect on mood could be associated with improvement in subjective cognitive symptomatology. The difference in the latency time of clinical response (1 week of LAC treatment, compared with the 2 weeks' latency time with fluoxetine) suggests the existence of different mechanisms of action possibly in relation to the activation of rapid support processes of neuronal activity.

Keywords: Dysthymic Disorder; Fluoxetine; l-Acetylcarnitine.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Acetylcarnitine / adverse effects
  • Acetylcarnitine / therapeutic use*
  • Aged
  • Aged, 80 and over
  • Aging*
  • Antidepressive Agents / adverse effects
  • Antidepressive Agents / therapeutic use*
  • Cognitive Dysfunction / drug therapy
  • Cognitive Dysfunction / physiopathology
  • Cognitive Dysfunction / psychology
  • Diagnostic and Statistical Manual of Mental Disorders
  • Double-Blind Method
  • Dysthymic Disorder / drug therapy*
  • Dysthymic Disorder / etiology
  • Dysthymic Disorder / physiopathology
  • Female
  • Fluoxetine / adverse effects
  • Fluoxetine / therapeutic use
  • Humans
  • Male
  • Nootropic Agents / adverse effects
  • Nootropic Agents / therapeutic use
  • Psychiatric Status Rating Scales
  • Severity of Illness Index
  • Therapeutic Equivalency
  • Time Factors


  • Antidepressive Agents
  • Nootropic Agents
  • Fluoxetine
  • Acetylcarnitine