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首页> 外文期刊>Journal of psychiatric research >A review of current evidence for acetyl-l-carnitine in the treatment of depression
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A review of current evidence for acetyl-l-carnitine in the treatment of depression

机译：乙酰左旋肉碱治疗抑郁症的最新证据综述

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Despite numerous antidepressants available, many patients with depression do not achieve adequate response rendering needs for novel antidepressants with different mechanism of actions. Acetyl l-carnitine (ALC) is a potential antidepressant with novel mechanism of action because of its diverse functions related with neuroplasticity. Animal and cellular models suggest that ALC's neuroplasiticity effect, membrane modulation, and neurotransmitter regulation may play an important role in treatment of depression. Four randomized clinical studies (RCT) demonstrated the superior efficacy of ALC over placebo (PBO) in patients with depression. Two RCTs showed its superior efficacy over PBO in dysthymic disorder, and 2 other RCTs showed that it is equally effective as fluoxetine and amisulpride in treatment of dysthymic disorder. ALC was also effective in improving depressive symptoms in patients with fibromyalgia and minimal hepatic encephalopathy. It was also found to be equally tolerable to PBO and better tolerable than fluoxetine and amisulpride. In conclusion, ALC may be potentially effective and tolerable next treatment option with novel action mechanisms for patients with depression, in particular older population and patients with comorbid medical conditions who are vulnerable to adverse events from antidepressants. However, more clinical trial data with adequately-powered, well-designed and advanced methodology will be mandatory to conclude whether ALC as a monotherapy or augmentation agent may be efficacious and clinically beneficial for depression.
机译：尽管有许多可用的抗抑郁药，但许多抑郁症患者仍未获得对具有不同作用机制的新型抗抑郁药的充分反应。乙酰基左旋肉碱（ALC）是一种潜在的抗抑郁药，具有新颖的作用机制，因为其与神经可塑性相关的多种功能。动物和细胞模型表明，ALC的神经质效应，膜调节和神经递质调节可能在抑郁症的治疗中起重要作用。四项随机临床研究（RCT）证明，抑郁症患者ALC优于安慰剂（PBO）。有2项RCT表现出了在运动障碍性疾病中优于PBO的功效，另外2项RCT显示出与氟西汀和氨磺必利同等的疗效。 ALC还可以有效改善纤维肌痛和轻度肝性脑病患者的抑郁症状。还发现它对PBO的耐受性相同，并且比氟西汀和氨磺必利的耐受性更好。总之，对于患有抑郁症的患者，特别是年龄较大的人群和易患抗抑郁药不良事件的合并病患者，ALC可能具有新的作用机制，可能是潜在有效且可耐受的下一治疗方案。但是，必须有更多具有足够能力，精心设计和先进方法的临床试验数据，才能得出结论：ALC作为单一疗法或增强剂是否对抑郁症有效且对临床有益。

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