title: Clinical correlates of low serum carnitine levels in hospitalized psychiatric patients.
abstract: OBJECTIVE
  We sought to evaluate clinical correlates of low serum carnitine levels in hospitalized psychiatric patients.
  
  
  METHODS
  We retrospectively reviewed the charts of 40 psychiatric inpatients identified to have low serum carnitine levels.
  
  
  RESULTS
  Cognitive impairment was present in 38 (95%) cases, frequently accompanied by imbalance, agitation and extrapyramidal symptoms. Valproate therapy was encountered in 28 (70%) patients. The dosage of valproate negatively correlated with total and free carnitine levels (P = 0.003 and 0.0136). Polypharmacy also affected carnitine levels, indicating additional modulatory effects on carnitine metabolism. We encountered a disproportionately high prevalence of mental retardation and dementia in association with hypocarnitinemia.
  
  
  CONCLUSIONS
  We hypothesize that in the context of mental illness hypocarnitinemia may be associated with metabolic encephalopathy and cognitive impairment. As carnitine deficiency is a potentially treatable condition further studies are warranted.
authors.affiliation: South Carolina Department of Mental Health and Department of Neuropsychiatry and Behavioral Science, University of South Carolina School of Medicine, Columbia, SC, USA. mirocuturic@yahoo.com
authors.forename: Miroslav
authors.initials: M
authors.lastname: Cuturic
authors.forename: Ruth K
authors.initials: RK
authors.lastname: Abramson
authors.forename: Robert R
authors.initials: RR
authors.lastname: Moran
authors.forename: James W
authors.initials: JW
authors.lastname: Hardin
authors.forename: Alicia V
authors.initials: AV
authors.lastname: Hall
mesh_terms: D000328:Adult; D000368:Aged; D018692:Antimanic Agents / Q000097:blood / Q000627:therapeutic use; D002331:Carnitine / Q000097:blood*; D005260:Female; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D008297:Male; D001523:Mental Disorders / Q000097:blood* / Q000188:drug therapy; D008875:Middle Aged; D019338:Polypharmacy; D012189:Retrospective Studies; D012559:Schizophrenia / Q000097:blood / Q000188:drug therapy; D014635:Valproic Acid / Q000097:blood / Q000627:therapeutic use
chemical_list: D018692:Antimanic Agents; D014635:Valproic Acid; D002331:Carnitine