ALC/ALA Treatment for Depression
A single possible serious ill effect of ALC/ALA was my reaction to an MAOI (antidepressant medication) that I have taken uneventfully for decades. This medication is seldom prescribed today due to its reputation for causing sudden hypertensive episodes in patients, particularly when combined with any of a long list of other drugs and foods. I had not ingested any of these forbidden substances when my blood pressure spiked without warning. Could the ALC/ALA have had a hand? Could it have sensitized me to the MAOI? At present this is under investigation.
An unexpected upside to the antidepressant dilemma emerged. I cut the MAOI dose by 2/3rds as a temporary measure while investigating options, expecting fully for depressive symptoms to re-emerge. More than a month has now passed with no symptoms. ALC/ALA has apparently at least partially taken over the job of the MAOI through repair to neurotransmitter synapses. Too early and too little information to call with certainty, but research supports ALC/ALA's function as an anti-depressant.**
Because MAO inhibitors are infrequently prescribed, this caution will not apply to most persons considering ALC/ALA treatment. Also, given the incidents of unexplained sudden hypertensive incidents known to occur with MAOI use, my own experience cannot be attributed to drug interaction with absolute certainty.
However I would caution anyone using ANY antidepressant (AD) that lowering their AD med dose may be called for some months into high dose ALC/ALA treatment.
At present I am continuing with a 10 mg daily dose of (MAOI) Parnate, down from 30 mgs, and keeping 2 anti-hypertensive meds on hand for sublingual use in the event of another hypertensive emergency. I am implementing a gradual increase in ALC/ALA dose with the intent of completely supplanting MAOI use with carnitine therapy.
The effects of ALC on cortisol levels have been varied. In one 40-day study of depressed elderly adults, significant normalization of elevated cortisol levels and improved scores on mood assessments resulted from ALC administration (0.5g/qid p.o.). In 43% of the patients, the treatment was so successful that they were determined to be in clinical remission.25 This supports an earlier study of 24 depressed adults treated over a 2-month period where the depressive symptoms improved to a high degree of significance, especially in the group with the most severe clinical presentation.26 However, in the study by Martignoni, with non-depressed healthy male volunteers, the intravenous administration of ALC raised cortisol levels along with ß-endorphin. It appears that ALC may have an amphoteric effect on cortisol levels, raising or lowering levels according to HPA feedback mechanisms.
John H. Furlong N.D.
In cases of major depression, it has been demonstrated that the circadian rhythm of cortisol
secretion appears to be altered, with depressed patients having an increase in total cortisol secretion.12
This is probably a result of an increased activation of the hypothalamo-pituitary-adrenocortical (HPA)
system. Animal studies have indicated ALC administration may have an inhibitory effect on HPA activity, resulting in a reduction of cortisol levels and thereby an improvement in depressive symptoms.
No data is available on ALC’s effectiveness in modulating HPA activity in humans.13 In a two month study of 24 depressed elderly patients it was demonstrated that ALC treatment was highly effective, particularly in patients with more serious depressive symptoms.14 In another study of 28 elderly patients, Garzya et al demonstrated that 500 mg ALC three times per day was effective in counteracting symptoms of depression. Patients in both studies were evaluated using the Hamilton Rating Scale for Depression, with decreased scores representing a relief of depressive symptomology.15
12. Gecele M, Francesetti G, Meluzzi A. Acetyl-L-carnitine in aged subjects with major depression: clinical efficacy and effects on the circadian rhythm of cortisol. Dementia 1991;2:333-337.
13. Angelucci L, Ramacci MT. Hypothalamo-pituitary-adrenocortical functioning in aging: Effects of acetyl-lcarnitine.
In: DeSimone C, Martelli EA, eds. Stress, Immunity and Aging, A Role for Acetyl-L-Carnitine.
Amsterdam: Elsevier; 1989.
14. Tempesta E, Casella L, Pirrongelli C, et al. L-acetylcarnitine in depressed elderly subjects. A cross-over study vs placebo. Drugs Exp Clin Res 1987;13:417-423.
15. Garzya G, Corallo D, Fiore A, et al. Evaluation of the effects of L-acetylcarnitine on senile patients suffering from depression. Drugs Exp Clin Res 1990;16:101-106.