Acetyl-L-carnitine and Amyotrophic Lateral Sclerosis: current evidence and potential use.

Degenerative brain disorders can be frustrating for conventional and alternative practitioners since conventional medicine has made very little progress in its treatment. For this reason, a more comprehensive, integrative approach is urgently needed. Among various emerging focus for intervention, the modulation of central nervous system energetics, oxidative stress, and inflammation are becoming more and more promising. In particular, electrons leakage involved in the mitochondrial energetics can generate reactive oxygen-free radical-related mitochondrial dysfunction that would contribute to the etiopathology of many such disorders, such as Alzheimer's and other dementias, Parkinson's disease, multiple sclerosis, stroke, and amyotrophic lateral sclerosis (ALS). In this context, using agents like acetyl L-carnitine (ALCAR) provides mitochondrial support, reduces oxidative stress, and improves synaptic transmission. This narrative review aims to update the existing literature on ALCAR molecular profile, tolerability, and translational clinical potential use in neurodegeneration, focusing on ALS.