Impact of L-carnitine in narcolepsy treatment: a systematic review on the effectiveness and safety

Abstract

Introduction:Studies have shown that narcolepsy patients may present with low serum acylcarnitine levels, demonstrating a dysfunctional beta fatty acid oxidation pathway in these patients. Objective: Evaluate the therapeutic efficacy of L-carnitine as a treatment for narcolepsy patients. Methods: This study runned in form of systematic review. The terms used for the search: ("narcolepsy"[MeSH Terms] OR "narcolepsy"[All Fields]) AND ("carnitine"[MeSH Terms] OR "carnitine"[All Fields] OR "l carnitine"[All Fields]). Were included all surveys published until January 2021, with the diagnosis of narcolepsy, that performed drug treatment with I-carnitine. The clinical endpoints of interest were: excessive daytime sleepiness, dissociative REM sleep manifestations: cataplexy, sleep paralysis, hypnagogic hallucinations, and early REM sleep (REM sleep naps, SOREMP). Results: L-carnitine was found to be well-tolerated and without side effects in all surveys, at dosages ranging from 500 to 510 mg/day. Newborns did not present complications during delivery. Conclusion: This study corroborates the efficacy and good tolerability of L-carnitine therapy as a treatment for patients with narcolepsy, including during pregnancy.

Narcolepsy: an interface among neurology, immunology, sleep, and genetics

“…56 Cataplexy Strong Low improvement of symptoms after treatment with L-carnitine at the onset of symptoms, including pregnancy, in a systematic review. 66,67 Authors observed that the therapeutic efficacy of L-carnitine as a treatment for patients with narcolepsy in a population of 31 patients showed improvement in EDS. 68 Other authors have shown symptomatic improvement after using prednisone and immunoglobulin.…”

Sleep Disorders in Children with Prader Willi Syndrome: Current Perspectives

“… 71 Furthermore, a recent systematic review found that carnitine supplementation was well tolerated, without side effects, and had some efficacy as a pharmacologic therapy for patients with narcolepsy. 72 This may be a particularly attractive option that is relatively benign compared to other pharmaceutical alternatives for hypersomnia in very young patients with PWS. To be sure, this is an area worthy of further investigation.…”