Alpha-lipoic acid in the treatment of psychiatric and neurological disorders: a systematic review

Abstract

Despite the existence of many preclinical studies, scientific evidence is lacking on the clinical use of alpha-lipoic acid (ALA) for central nervous system disorders. Therefore, we aimed at revising the literature concerning the use of ALA for the treatment of psychiatric and neurological conditions and to point out what is missing for the introduction of this antioxidant to this purpose. For this systematic review we performed a search using PubMed and SCOPUS databases with the following keywords: “alpha-Lipoic Acid AND central nervous system OR psychiatric disorders OR neurological disorders OR mood disorders OR anxiety OR psychosis OR Alzheimer OR Parkinson OR stroke”. The total number of references found after automatically and manually excluding duplicates was 1061. After primary and secondary screening 32 articles were selected. Regarding psychiatric disorders, the studies of ALA in schizophrenia are advanced being ALA administration related to the improvement of schizophrenia symptoms and side effects of antipsychotic medication. In neurological disorders, ALA as a supplement was effective in the prevention of Alzheimer disease progression. For stroke, the use of the supplement ALAnerv® (containing 300 mg ALA) presented important results, since it was observed a reversal of clinical parameters and oxidative imbalance in these patients. For other neurological conditions, such as encephalopathy, multiple sclerosis, traumatic brain injury, mitochondrial disorders and migraine, the results are still preliminary. Overall, there is a need of well-designed clinical trials to enhance the clinical evidences of ALA effects for the treatment of neurological and psychiatric conditions.

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Abbreviations

AD:

Alzheimer disease

ADL/IADL:

Activities of Daily Living/Instrumental Activities of Daily Living

ADAScog:

Alzheimer’s disease assessment score cognitive subscale

AIDS:

acquired immunodeficiency syndrome

ALA:

alpha-lipoic acid

AOPP:

advanced oxidation protein products

CGI-S:

Clinical Global Impression Scale for Severity

CNS:

central nervous system

DMR SOC:

Dementia Questionnaire for Mentally Retarded Persons sum of cognitive scores

HAM-D:

Hamilton Depression Rating Scale

HIV-1:

human immunodeficiency virus type 1

IADL:

Instrumental Activities of Daily Living

MADRS:

Montgomery-Asberg Depression Rating Scale

MMSE:

Mini-Mental State Examination

TAS:

total antioxidant status

TBARS:

thiobarbituric acid-reactive substances

YMRS:

Young Mania Rating Scale.

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Acknowledgments

This study was supported by grants from the Brazilian National Council for Scientific and Technological Development (CNPq), Higher Education Personnel Improvement Coordination (CAPES) and Cearense Foundation for the Support of Scientific and Technological Development (FUNCAP).

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The authors declare no conflict of interests.

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Correspondence to Silvânia Maria Mendes Vasconcelos.

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de Sousa, C.N.S., da Silva Leite, C.M.G., da Silva Medeiros, I. et al. Alpha-lipoic acid in the treatment of psychiatric and neurological disorders: a systematic review. Metab Brain Dis 34, 39–52 (2019). https://doi.org/10.1007/s11011-018-0344-x

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Keywords

  • Alpha-lipoic acid
  • Central nervous system
  • Neurological disorders
  • Psychiatric disorders