Carnitine does not improve weight loss outcomes in valproate-treated bipolar patients consuming an energy-restricted, low-fat diet.
OBJECTIVE
Carnitine deficiency impairs fatty acid beta-oxidation and may partly explain weight gain in valproate-treated patients. The aim of this study was to determine whether l-carnitine supplementation improves weight loss outcomes in bipolar patients taking sodium valproate.


METHODS
Sixty bipolar patients with clinically significant weight gain thought to be related to sodium valproate, who had been taking sodium valproate for >or=6 months, were randomized to l-carnitine (15 mg/kg/day) or placebo for 26 weeks, in conjunction with a moderately energy-restricted, low-fat diet. The primary outcome measure was weight change.


RESULTS
l-carnitine had no effect on mean weight loss compared with placebo (-1.9 kg versus - 0.9 kg) (F = 0.778, df = 1,58, p = 0.381). The number of people in each group able to lose any weight was identical ( = 0, p = 1.0); more patients in the carnitine group (nine versus five) achieved a clinically significant weight loss (>or=5%) but this was not statistically significant (p = 1.0, Fisher's exact test).


CONCLUSIONS
At the dose prescribed in this study carnitine supplementation did not improve weight loss outcomes in valproate-treated bipolar patients consuming an energy-restricted, low-fat diet.
Elmslie
Jane L
JL
Department of Psychological Medicine, Christchurch School of Medicine and Health Sciences, Christchurch, New Zealand. jane.elmslie@chmeds.ac.nz
Porter
Richard J
RJ
Joyce
Peter R
PR
Hunt
Penelope J
PJ
Mann
Jim I
JI
D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000188:drug therapy*; D015992:Body Mass Index; D002331:Carnitine / Q000008:administration & dosage* / Q000172:deficiency; D018752:Diet, Fat-Restricted; D004038:Diet, Reducing; D002149:Energy Intake; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D014635:Valproic Acid / Q000009:adverse effects* / Q000627:therapeutic use; D015431:Weight Loss / Q000187:drug effects*
D000927:Anticonvulsants; D014635:Valproic Acid; D002331:Carnitine