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l‐Carnitine Supplementation for the Treatment of Fatigue and Depressed Mood in Cancer Patients with Carnitine Deficiency: A Preliminary Analysis
Author(s) -
CRUCIANI R A,
DVORKIN E,
HOMEL P,
CULLINEY B,
MALAMUD S,
SHAIOVA L,
FLEISHMAN S,
LAPIN J,
KLEIN E,
LESAGE P,
PORTENOY R,
ESTEBANCRUCIANI N
Publication year - 2004
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1196/annals.1320.016
Subject(s) - carnitine , medicine , quality of life (healthcare) , depression (economics) , micronutrient , gastroenterology , population , placebo , randomized controlled trial , mood , psychiatry , alternative medicine , nursing , environmental health , pathology , economics , macroeconomics
A bstract : Nutritional factors are among the postulated causes of fatigue, a highly prevalent symptom in the cancer population, with serious impact on patients’ quality of life. Deficiency of the micronutrient carnitine may play a role by reducing energy production through fatty acid oxidation. We present preliminary data of an open‐label, dose‐finding study to determine safety and maximally tolerated dose (MTD) of 1 week of l‐carnitine supplementation in cancer patients with fatigue and carnitine deficiency. Patients who met inclusion/exclusion criteria underwent carnitine level determination. Eighty‐three percent of these patients (15/18) had carnitine deficiency. Preliminary data analysis of 13 patients showed that total carnitine increased from 30.0 ± 6.9 to 41.0 ± 12.1 (mean ± SD) after 1 week of supplementation ( P = 0.01), and free carnitine increased from 24.3 ± 6.1 to 33.8 ± 9.8 ( P = 0.004). Outcome measures were fatigue (BFI score), depression (CES‐D), sleep disruption (ESS), and performance status (Karnofsky). Median (min, max) BFI score at baseline was 73 (46, 82) versus 50 (3, 82) after 1‐week supplementation ( P = 0.009). CES‐D score at baseline was 29 (16, 42) and 22 (8, 32) after 1 week ( P = 0.028). ESS at baseline was 46.5 (0, 69) and 30.4 (0, 72) after 1 week ( P = 0.015). Karnofsky score did not change significantly ( P = 0.38). We are currently conducting a randomized, double‐blind, placebo‐controlled study to rigorously assess the role of l‐carnitine for the treatment of fatigue and depression in cancer patients.