Double-blind parallel design pilot study of acetyl levocarnitine in patients with Alzheimer's disease
M. Sano, K. Bell, L. Cote, G. Dooneief, A. Lawton, L. Legler, K. Marder, A. Naini, Y. Stern and R. Mayeux
Department of Neurology, Columbia University, College of Physicians and Surgeons, New York, NY.
Acetyl levocarnitine hydrochloride has been reported to retard dementia in
patients with Alzheimer's disease. In a double-blind, parallel design,
placebo-controlled pilot study of 30 mild to moderately demented patients
with probable Alzheimer's disease, tests of memory, attention, language,
visuospatial, and constructional abilities were administered, and the level
of acetyl levocarnitine was measured in the cerebrospinal fluid. Patients
were then randomly assigned to receive acetyl levocarnitine hydrochloride
(2.5 g/d for 3 months followed by 3 g/d for 3 months) or placebo. After 6
months, the acetyl levocarnitine group demonstrated significantly less
deterioration in timed cancellation tasks and Digit Span (forward) and a
trend toward less deterioration in a timed verbal fluency task. No
differences were found in any other neuropsychological test results. A
subgroup with the lowest baseline scores, receiving acetyl levocarnitine,
had significantly less deterioration on the verbal memory test and a
significant increase in cerebrospinal fluid acetyl levocarnitine levels
compared with those receiving placebo. These results suggest that acetyl
levocarnitine may retard the deterioration in some cognitive areas in
patients with Alzheimer's disease and stress the need for a larger study of
this drug.