title: Acetyl-L-carnitine reduces depression and improves quality of life in patients with minimal hepatic encephalopathy.
abstract: BACKGROUND
  Minimal hepatic encephalopathy (MHE) represents a common complication present in well-compensated cirrhotic patients that impairs patients' daily functioning and health-related quality of life (HRQL). Acetyl-L-carnitine (ALC) has been shown to be useful in improving blood ammonia and cognitive functions in cirrhotic patients with MHE.
  
  
  OBJECTIVE
  This study evaluated the effects of ALC treatment on HRQL and depression in patients with MHE.
  
  
  METHODS
  This was a randomized, double-blind, placebo-controlled study. Sixty-seven patients with MHE were recruited to the study. They were randomly assigned to two groups and received either 2 g acetyl-L-carnitine twice a day (n = 33) or placebo (n = 34) for 90 days. The primary efficacy measures were changes in aspartate aminotransferase, alanine aminotransferase, γ-glutamyl-transpeptidase, albumin, alkaline phosphatase, prothrombin time, and ammonia. Clinical and laboratory assessments, psychometric tests and automated electroencephalogram (EEG) analysis were performed for all patients.
  
  
  RESULTS
  At the end of the study period, between the two groups, we observed a significant difference in physical function (p < 0.001), role physical (p < 0.001), general health (p < 0.001), social function (p < 0.05), role emotional (p < 0.05), mental health (p < 0.05), Beck Depression Inventory (p < 0.001), TMT-B s (p < 0.001), State Trait Inventory (p < 0.001), urea (p < 0.05), NH(4)(+) (p < 0.001), and bilirubin (p < 0.001).
  
  
  CONCLUSIONS
  This study shows that ALC treatment is associated with significant improvement in patient energy levels, general functioning and well-being. The improvement of quality of life is associated with reduction of anxiety and depression.
authors: Department of Senescence, Urological and Neurological Sciences, University of Catania, Ospedale Cannizzaro, Catania, Italy. malaguar@unict.it
authors: Mariano
authors: M
authors: Malaguarnera
authors: Rita
authors: R
authors: Bella
authors: Marco
authors: M
authors: Vacante
authors: Maria
authors: M
authors: Giordano
authors: Giulia
authors: G
authors: Malaguarnera
authors: Maria Pia
authors: MP
authors: Gargante
authors: Massimo
authors: M
authors: Motta
authors: Antonio
authors: A
authors: Mistretta
authors: Liborio
authors: L
authors: Rampello
authors: Giovanni
authors: G
authors: Pennisi
mesh_terms: D000108:Acetylcarnitine / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000188:drug therapy; D003866:Depressive Disorder / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D006501:Hepatic Encephalopathy / Q000188:drug therapy*; D006801:Humans; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D018697:Nootropic Agents / Q000627:therapeutic use*; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology; D016896:Treatment Outcome
chemical_list: D018697:Nootropic Agents; D000108:Acetylcarnitine