Acetyl-L-carnitine

Class

Nutraceutical / mitochondrial enhancer

Mechanism

Multifactorial; centers on its role as an acetyl group donor and facilitator of mitochondrial energy metabolism; enhances mitochondrial energy metabolism, supports neurotransmission and neuroplasticity

FDA-Approved Use

None

Off-Label Use

Late-life depression, mild cognitive impairment (MCI), post-stroke recovery

Formulation

Oral capsules and tablets (over-the-counter supplement)

Titration

500 mg p.o. once or twice daily; titrate based on clinical response and tolerability

Dose Range

500–2000 mg/day divided doses

Kinetics

Orally absorbed; crosses blood-brain barrier; limited half-life data

Common AEs

Nausea, insomnia, restlessness

Serious/Rare AEs

None well documented

Monitoring

None routinely required; monitor for agitation or seizure worsening in vulnerable patients

Black Box Warning

None

Considerations

May support cognition and energy in older adults, stroke survivors, and individuals with neurodegenerative conditions. Minimal drug interactions reported, though long-term safety data are limited. Use cautiously with monitoring in patients with seizure disorders or agitation.