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首页> 外文期刊>Journal of clinical psychopharmacology >A placebo-controlled trial of acetyl-l-carnitine and α-lipoic acid in the treatment of bipolar depression
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A placebo-controlled trial of acetyl-l-carnitine and α-lipoic acid in the treatment of bipolar depression

机译：安慰剂对照的乙酰左旋肉碱和α-硫辛酸治疗双相抑郁症的研究

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BACKGROUND: Bipolar disorder may be associated with mitochondrial dysfunction. Therefore, agents that enhance mitochondrial functioning may be efficacious in bipolar disorder. We performed a randomized placebo-controlled trial of the mitochondrial enhancers acetyl-L-carnitine (ALCAR) and α-lipoic acid (ALA) in patients with bipolar depression, and assessed markers of cerebral energy metabolism using phosphorus magnetic resonance spectroscopy. METHODS: We administered ALCAR (1000-3000 mg daily) plus ALA (600-1800 mg daily) or placebo for 12 weeks to 40 patients with bipolar depression and obtained imaging data at baseline, week 1, and week 12 of treatment in 20 patients using phosphorus 3-dimensional chemical-shift imaging at 4 T. Statistical analysis used random effects mixed models. RESULTS: We found no significant difference between ALCAR/ALA and placebo on change from baseline in the Montgomery-Asberg Depression Rating Scale in both the longitudinal (mean difference [95% confidence interval], -1.4 [-6.2 to 3.4], P = 0.58) and last-observation-carried-forward (-3.2 [-7.2 to 0.9], P = 0.12) analyses. ALCAR/ALA treatment significantly reduced phosphocreatine levels in the parieto-occipital cortex at week 12 (P = 0.002). Reduction in whole brain total nucleoside triphosphate levels from baseline to week 1 was associated with reduction in Montgomery-Asberg Depression Rating Scale scores (P = 0.02) in patients treated with ALCAR/ALA. However, this was likely a chance finding attributable to multiple statistical comparisons. CONCLUSIONS: Treatment with ALCAR and ALA at the dose and duration used in this study does not have antidepressant effects in depressed bipolar patients and does not significantly enhance mitochondrial functioning in this patient group.
机译：背景：双相情感障碍可能与线粒体功能障碍有关。因此，增强线粒体功能的药物在双相情感障碍中可能有效。我们对患有双相抑郁症的患者进行了线粒体增强剂乙酰基-L-肉碱（ALCAR）和α-硫辛酸（ALA）的随机安慰剂对照试验，并使用磷磁共振波谱法评估了脑能量代谢的标志物。方法：我们对40例双相抑郁症患者给予ALCAR（每天1000-3000 mg）加ALA（每天600-1800 mg）或安慰剂治疗12周，并在20例患者的基线，治疗第1周和第12周获得了影像学数据在4 T下使用磷3维化学位移成像。统计分析使用随机效应混合模型。结果：在蒙哥马利-阿斯伯格抑郁量表中，从纵向变化来看，ALCAR / ALA与安慰剂之间的基线变化无明显差异（均值差[95％置信区间]，-1.4 [-6.2至3.4]，P = 0.58）和最后一个观察结转（-3.2 [-7.2至0.9]，P = 0.12）分析。 ALCAR / ALA治疗在第12周时显着降低了顶枕皮质的磷酸肌酸水平（P = 0.002）。从基线到第1周，全脑总核苷三磷酸水平的降低与接受ALCAR / ALA治疗的患者的蒙哥马利-阿斯伯格抑郁量表评分（P = 0.02）降低有关。但是，这很可能是由于多个统计比较而引起的。结论：在这项研究中使用的剂量和持续时间的ALCAR和ALA治疗对抑郁的双相型患者没有抗抑郁作用，并且在该患者组中并未显着增强线粒体功能。

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