Amantadine and L-carnitine treatment of Chronic Fatigue Syndrome, 1997, Plioplys et al

[Dolphin]

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https://pubmed.ncbi.nlm.nih.gov/9018019/

Amantadine and L-carnitine treatment of Chronic Fatigue Syndrome

A V Plioplys 1, S Plioplys

Neurobiology 1997;35(1):16-23. doi: 10.1159/000119325.

• PMID: 9018019
  
• DOI: 10.1159/000119325

Abstract


Carnitine is essential for mitochondrial energy production. Disturbance in mitochondrial function may contribute to or cause the fatigue seen in Chronic Fatigue Syndrome (CFS) patients. Previous investigations have reported decreased carnitine levels in CFS. Orally administered L-carnitine is an effective medicine in treating the fatigue seen in a number of chronic neurologic diseases. Amantadine is one of the most effective medicines for treating the fatigue seen in multiple sclerosis patients. Isolated reports suggest that it may also be effective in treating CFS patients. Formal investigations of the use of L-carnitine and amantadine for treating CFS have not been previously reported.

We treated 30 CFS patients in a crossover design comparing L-carnitine and amantadine. Each medicine was given for 2 months, with a 2-week washout period between medicines. L-Carnitine or amantadine was alternately assigned as fist medicine.

Amantadine was poorly tolerated by the CFS patients. Only 15 were able to complete 8 weeks of treatment, the others had to stop taking the medicine due to side effects. In those individuals who completed 8 weeks of treatment, there was no statistically significant difference in any of the clinical parameters that were followed.

However, with L-carnitine we found statistically significant clinical improvement in 12 of the 18 studied parameters after 8 weeks of treatment. None of the clinical parameters showed any deterioration. The greatest improvement took place between 4 and 8 weeks of L-carnitine treatment. Only 1 patient was unable to complete 8 weeks of treatment due to diarrhea.

L-Carnitine is a safe and very well tolerated medicine which improves the clinical status of CFS patients. In this study we also analyzed clinical and laboratory correlates of CFS symptomatology and improvement parameters.

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Note that 3000 mg per day of l-carnitine was used; I suspect a lot of people with ME/CFS who hear about l-carnitine don't try it at that sort of dosage. Also some people try acetyl l-carnitine, whose effects are more on the brain from what I understand.

 

[Dolphin]

Maeve knew and understood this. She died because she knew more about ME than anyone she ever met. Even Dr Weir could not understand why 3g l-Carnitine daily had helped slow her descent into the living hell of very severe ME – but she did. She was a fine scholar, and a good teacher.

https://virology.ws/2024/08/15/tria...e-into-the-inquests-findings-and-conclusions/

3g/day is the dosage in this trial

 

[forestglip]

Full text as PDF

All 28 patients were able to tolerate L-carnitine for 4 weeks. In 1 female patient, abdominal pain and diarrhea occurred after the 4th week causing her to stop taking this medicine before completion of the 8th week. A temporary discontinuation for 1 week of L-carnitine did not prevent recurrence of symptoms when the medicine was reintroduced.

The results from baseline to 4 weeks of L-carnitine treatment are presented in table 4. In 5 of the 18 psychometric tests and subtests there was a statistically significant improvement. It should be noted that with the results of the CFS-II an increase in scores indicates an improvement in function, whereas in all of the rest, an increase in scores indicates deteriorating function. There was no subset in which there was a deterioration in the score after 4 weeks of L-carnitine treatment.

The results from baseline to 8 weeks with L-carnitine are presented in table 5. In 12 of the 18 psychometric tests and subtests there was a statistically significant improvement. In addition, there were no tests or subtests in which deterioration was exhibited. Of note, all subtests improved over 8 weeks. Moreover, when comparing table 4 to table 5 results, most of the improvement seen with L-carnitine took place between weeks 4 and 8.

During the treatment program with L-carnitine, when comparing the results both at 4 and at 8 weeks, there was no significant difference between the 14 patients treated first with L-carnitine and the 14 treated with L-carnitine as the second medicine in any of the psychometric test and subtest results.

The degree of improvement with L-carnitine in each of the psychometric parameters studied was calculated by subtracting the baseline from the 8-week results. The degree of improvement in all of the psychometric parameters studied revealed no significant association with age, sex or mode of onset of illness. The only associations detected were between improvement in the OCI of the SCL-90-R and acylcarnitine levels (p < 0.05), between improvement in the CFS-II Total score and acylcarnitine levels (p < 0.05), and between improvement in the Somatization Index (SI) of SCL-90-R and duration of illness (p < 0.05). These results indicate that those patients who had higher acylcarnitine levels improved more in the OCI and CFS-II Total scores with L-carnitine. These results also indicate that those who had a shorter duration of illness improved more in the SI with the use of L-carnitine. There were no other statistically significant associations exhibited between improvement in psychometric tests and free carnitine and total carnitine levels.

We compared the degree of improvement with the baseline psychometric results at the start of taking L-carnitine. The degree of improvement was significantly associated with the degree of severity for a number of tests used (Spearman nonparametric correlation coefficients): SI of the SCL-90-R (p = 0.004); DI of the SCL-90-R (p = 0.001); Anxiety Index of the SCL-90-R (p = 0.000); GSI of the SCL-90-R (p = 0.001); Positive Symptom Total of the SCL-90-R (p = 0.006); BDI (p = 0.000); FSS (p = 0.028). There were no other psychometric tests or subtests found which were associated with the degree of improvement.

All patients met the CDC criteria for the diagnosis of CFS [30]. Also, all of the patients met the Australian and British definitions of CFS [28, 29]. Reviewing the charts retrospectively, all patients also met the newly revised CDC criteria for CFS [31].

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31 Fukuda K, Strauss SE, Hickie I, et al: The
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