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Child Psychiatry & Human Development

, Volume 42, Issue 3, pp 367–375 | Cite as

Acetyl-L-Carnitine as an Adjunctive Therapy in the Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents: A Placebo-Controlled Trial

  • Seyed-Hesameddin Abbasi
  • Shahram Heidari
  • Mohammad-Reza Mohammadi
  • Mina Tabrizi
  • Ali Ghaleiha
  • Shahin AkhondzadehEmail author
Original Article

Abstract

The objective of this study was to test whether a previous observed Acetyl-L-carnitine (ALC) treatment effect could be repeated in an ALC adjunctive therapy treatment trial of attention-deficit/hyperactivity disorder (ADHD) in children and adolescents. This was a six-week, randomized clinical trial undertaken in an outpatient child and adolescent clinic. Subjects included 40 outpatients (28 boys and 12 girls) between the ages of 7–13 who met the DSM-IV-TR diagnostic criteria for ADHD. All study subjects were randomly assigned to receive treatment using capsules of ALC doses ranging from 500 to 1,500 mg/day depending on the weight of the child plus methylphenidate at a dose of 20–30 mg/day depending on weight or Placebo plus methylphenidate at a dose of 20–30 mg/day depending on weight. The principal measure of outcome was the Teacher and Parent attention deficit/hyperactivity disorder Rating Scale- IV. No difference was observed between the two groups on the Parent and Teacher Rating Scale scores (df = 1; F = 0.10; P = 0.74 and df = 1; F = 0.22; P = 0.63 respectively). Side effects consisting of headache and irritability were observed more frequently in the methylphenidate plus placebo group. The results of this study do not support the application of ALC as an adjunctive therapy to methylphenidate in children and adolescents with ADHD.

Keywords

ADHD Acetyl-L-carnitine Clinical trial Methylphenidate 

Notes

Acknowledgments

This study was the post graduate thesis of Dr. Shahram Heidari toward the Iranian board of child psychiatry. This study was supported by a grant from Tehran University of Medical Sciences (Grant No: 8642) to Prof. Shahin Akhondzadeh.

Conflict of interest

All authors declare no conflict of interest.

References

  1. 1.
    Noorbala AA, Akhondzadeh S (2006) Attention-deficit/hyperactivity disorder: etiology and pharmacotherapy. Arch Iranian Med 9:374–380Google Scholar
  2. 2.
    Mohammadi MR, Akhondzadeh S (2007) Pharmacotherapy of attention-deficit/hyperactivity disorder: nonstimulant medication approaches. Exp Rev Neurotrapeutics 7:195–201CrossRefGoogle Scholar
  3. 3.
    Curatolo P, Paloscia C, D’Agati E, Moavero R, Pasini A (2009) The neurobiology of attention deficit/hyperactivity disorder. Eur J Paediatr Neurol 13:299–304PubMedCrossRefGoogle Scholar
  4. 4.
    Dopheide JA, Pliszka SR (2009) Attention-deficit-hyperactivity disorder: an update. Pharmacotherapy 29:656–679PubMedCrossRefGoogle Scholar
  5. 5.
    Adriani W, Rea M, Baviera M, Invernizzi W, Carli M, Ghirardi O, Caprioli A, Laviola G (2004) Acetyl-L-carnitine reduces impulsive behaviour in adolescent rats. Psychopharmacology (Berl) 176:296–304CrossRefGoogle Scholar
  6. 6.
    Rebouche CJ (2004) Kinetics, pharmacokinetics, and regulation of L-carnitine and acetyl-L-carnitine metabolism. Ann NY Acad Sci 1033:30–41PubMedCrossRefGoogle Scholar
  7. 7.
    Van Oudheusden LJ, Scholte HR (2002) Efficacy of carnitine in the treatment of children with attention-deficit hyperactivity disorder. Prostaglandins Leukot Essent Fatty Acids 67:33–38PubMedCrossRefGoogle Scholar
  8. 8.
    Torrioli MG, Vernacotola S, Peruzzi L, Tabolacci E, Mila M, Militerni R, Musumeci S, Ramos FJ, Frontera M, Sorge G, Marzullo E, Romeo G, Vallee L, Veneselli E, Cocchi E, Garbarino E, Moscato U, Chiurazzi P, D’Iddio S, Calvani M, Neri G (2008) A double-blind, parallel, multicenter comparison of L-acetylcarnitine with placebo on the attention deficit hyperactivity disorder in fragile X syndrome boys. Am J Med Genet A 146:803–812PubMedGoogle Scholar
  9. 9.
    Arnold LE, Amato A, Bozzolo H, Hollway J, Cook A, Ramadan Y, Crowl L, Zhang D, Thompson S, Testa G, Kliewer V, Wigal T, McBurnett K, Manos M (2007) Acetyl-L-carnitine (ALC) in attention-deficit/hyperactivity disorder: a multi-site, placebo-controlled pilot trial. J Child Adolesc Psychopharmacol 17:791–802PubMedCrossRefGoogle Scholar
  10. 10.
    American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders, 4th edn, text revision (DSMIV- TR). American Psychiatric Association, WashingtonCrossRefGoogle Scholar
  11. 11.
    Ghanizadeh A, Mohammadi MR, Yazdanshenas A (2006) Psychometric properties of the Farsi translation of the Kiddie schedule for affective disorders and Schizophrenia- present and lifetime version. BMC Psychiatry 15(6):10CrossRefGoogle Scholar
  12. 12.
    DuPaul G, Power T, Anastopoulos A, Reid R (1998) ADHD rating scale-IV. Guilford, New YorkGoogle Scholar
  13. 13.
    Akhondzadeh S, Tavakolian R, Davari-Ashtiani R, Arabgol F, Amini H (2003) Selegiline in the treatment of attention-deficit hyperactivity disorder in children: a double-blind and randomized trial. Prog Neuropsychopharmacol Biol Psychiatry 27:841–845PubMedCrossRefGoogle Scholar
  14. 14.
    Akhondzadeh S, Mohammadi MR, Khademi M (2004) Zinc sulfate as an adjunct to methylphenidate for the treatment of attention deficit hyperactivity disorder in children: a double blind and randomized trial [ISRCTN64132371]. BMC Psychiatry 8(4):9CrossRefGoogle Scholar
  15. 15.
    Amiri S, Mohammadi MR, Mohammadi M, Nouroozinejad GH, Kahbazi M, Akhondzadeh S (2008) Modafinil as a treatment for attention-deficit/hyperactivity disorder in children and adolescents: a double blind, randomized clinical trial. Prog Neuropsychopharmacol Biol Psychiatry 32:145–149PubMedCrossRefGoogle Scholar
  16. 16.
    Kahbazi M, Ghoreishi A, Rahiminejad F, Mohammadi MR, Kamalipour A, Akhondzadeh S (2009) A randomized, double-blind and placebo-controlled trial of modafinil in children and adolescents with attention deficit and hyperactivity disorder. Psychiatry Res 168:234–237PubMedCrossRefGoogle Scholar
  17. 17.
    Salehi B, Imani R, Mohammadi MR, Fallah J, Mohammadi M, Ghanizadeh A, Tasviechi AA, Vossoughi A, Rezazadeh SA, Akhondzadeh S (2010) Ginkgo biloba for attention-deficit/hyperactivity disorder in children and adolescents: a double blind, randomized controlled trial. Prog Neuropsychopharmacol Biol Psychiatry 34:76–80PubMedCrossRefGoogle Scholar
  18. 18.
    Zarinara AR, Mohammadi MR, Hazrati N, Tabrizi M, Rezazadeh SA, Rezaie F, Akhondzadeh S (2010) Venlafaxine versus methylphenidate in pediatric outpatients with attention deficit hyperactivity disorder: a randomized, double-blind comparison trial. Hum Psychopharmacol 25:530–535PubMedGoogle Scholar
  19. 19.
    Banaschewski T, Roessner V, Dittmann RW, Santosh PJ, Rothenberger A (2004) Non-stimulant medications in the treatment of ADHD. Eur Child Adolesc Psychiatry 13(suppl 1):102–116Google Scholar
  20. 20.
    Arduini A, Denisova N, Virmani A, Avrova N, Federici G, Arrigoni-Martelli E (1994) Evidence for the involvement of carnitine dependent long-chain acyltransferases in neuronal triglyceride and phospholipid fatty acid turnover. J Neurochem 62:1530–1538PubMedCrossRefGoogle Scholar
  21. 21.
    Richardson AJ, Ross MA (2000) Fatty acid metabolism in neurodevelopmental disorder: a new prospective on associations between attention-deficit/hyperactivity disorder, dyslexia, dyspraxia and the autistic spectrum. Prostaglandins Leukotr Essent Acids 63:1–9CrossRefGoogle Scholar
  22. 22.
    Calvani M, Arrigoni-Martelli E (1999) Attenuation by acetyl-L-carnitine of neurological damage and biochemical derangement following brain ischemia and reperfusion. Int J Tissue React 21:1–6PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Seyed-Hesameddin Abbasi
    • 1
  • Shahram Heidari
    • 2
  • Mohammad-Reza Mohammadi
    • 2
  • Mina Tabrizi
    • 3
  • Ali Ghaleiha
    • 4
  • Shahin Akhondzadeh
    • 2
    Email author
  1. 1.Central HospitalNational Iranian Oil Company Health OrganizationTehranIran
  2. 2.Psychiatric Research Centre, Roozbeh HospitalTehran University of Medical SciencesTehranIran
  3. 3.Department of Medical Genetics, Faculty of MedicineTehran University of Medical SciencesTehranIran
  4. 4.Research Center for Behavioral Disorders and Substance AbuseHamadan University of Medical SciencesHamadanIran

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