Amantadine & L-carnitine treatment of Chronic Fatigue Syndrome (CFS)

Carnitine is essential for mitochondrial energy production.
Disturbance in mitochondrial function may contribute to or
cause the fatigue seen in Chronic Fatigue Syndrome (CFS)
patients. Previous investigations have reported decreased
carnitine levels in CFS. Orally administered L-carnitine is
an effective medicine in treating the fatigue seen in a
number of chronic neurologic diseases. Amantadine is one of
the most effective medicines for treating the fatigue seen in
multiple sclerosis patients. Isolated reports suggest that it
may also be effective in treating CFS patients. Formal
investigations of the use of L-carnitine and amantadine for
treating CFS have not been previously reported. We treated 30
CFS patients in a crossover design comparing L-carnitine and
amantadine. Each medicine was given for 2 months, with a
2-week washout period between medicines. L-Carnitine or
amantadine was alternately assigned as fist medicine.

Amantadine was poorly tolerated by the CFS patients. Only 15
were able to complete 8 weeks of treatment, the others had to
stop taking the medicine due to side effects. In those
individuals who completed 8 weeks of treatment, there was no
statistically significant difference in any of the clinical
parameters that were followed. However, with L-carnitine we
found statistically significant clinical improvement in 12 of
the 18 studied parameters after 8 weeks of treatment. None of
the clinical parameters showed any deterioration. The
greatest improvement took place between 4 and 8 weeks of
L-carnitine treatment. Only 1 patient was unable to complete
8 weeks of treatment due to diarrhea. L-Carnitine is a safe
and very well tolerated medicine which improves the clinical
status of CFS patients. In this study we also analyzed
clinical and laboratory correlates of CFS symptomatology and
improvement parameters.

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