Abstract
Carnitine deficiency impairs fatty acid beta-oxidation and may partly explain weight gain in valproate-treated patients. The aim of this study was to determine whether l-carnitine supplementation improves weight loss outcomes in bipolar patients taking sodium valproate. Sixty bipolar patients with clinically significant weight gain thought to be related to sodium valproate, who had been taking sodium valproate for >or=6 months, were randomized to l-carnitine (15 mg/kg/day) or placebo for 26 weeks, in conjunction with a moderately energy-restricted, low-fat diet. The primary outcome measure was weight change. l-carnitine had no effect on mean weight loss compared with placebo (-1.9 kg versus - 0.9 kg) (F = 0.778, df = 1,58, p = 0.381). The number of people in each group able to lose any weight was identical ( = 0, p = 1.0); more patients in the carnitine group (nine versus five) achieved a clinically significant weight loss (>or=5%) but this was not statistically significant (p = 1.0, Fisher's exact test). At the dose prescribed in this study carnitine supplementation did not improve weight loss outcomes in valproate-treated bipolar patients consuming an energy-restricted, low-fat diet.
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