DOES CARNITINE ADMINISTRATION IMPROVE THE SYMPTOMS ATTRIBUTED TO ANTICONVULSANT MEDICATIONS - A DOUBLE-BLINDED, CROSSOVER STUDY

Objective. This study was designed to assess the reported improvement in ''well-being'' perceived by parents when children who are taking an ticonvulsant medications are administered carnitine. Methodology. Fort y-seven children with seizures who were taking either valproic acid or carbamazepine were enrolled in a placebo-controlled, double-blinded, crossover study of the effects of oral carnitine administration (100 m g/kilo) on their well-being as perceived by their parents. The well-be ing scores were assessed weekly by phone and in person at the start an d end of each 4-week phase. Results. The children's well-being scores improved weekly when either placebo or carnitine were administered. No ne of the analyses of improved well-being achieved statistical signifi cance. Conclusion. We believe this study documents the necessity for c ontrolled trials when assessing the subjective, beneficial effects of medications. Carnitine is expensive, costing approximately $.30/kilogr am of body weight per day ($6 per day for a 20 kilo child). It would n ot appear warranted to administer carnitine prophylactically to childr en on anticonvulsant medications for alleviating common, nonspecific s ymptoms. Because there are no reliable clinical or laboratory tests of symptomatic carnitine deficiency caused by anticonvulsant administrat ion, how to identify children in need of carnitine, and when to admini ster carnitine therapeutically to children receiving valproate or othe r anticonvulsants is unclear.