Twenty-five patients with grade 3 neuropathy during paclitaxel or cisplatin therapy, or grade 2 neuropathy persisting for at least 3 months after discontinuing these drugs, received acetyl-L-carnitine at a dose of 1 gram 3 times a day for eight weeks. All patients except one reported symptomatic relief. The sensory neuropathy grade improved in 15 of 25 patients (60%), and motor neuropathy improved in 11 of 14 patients (79%). Total neuropathy score improved in 92% of the patients. Symptomatic improvement persisted in 12 of 13 evaluable patients a median 13 months after acetyl-L-carnitine treatment. Side effects were mild nausea in two patients.

Comment: Certain chemotherapy drugs produce a neuropathy that can be disabling and persistent. Previous studies have shown that acetyl-L-carnitine is beneficial in the treatment of both diabetic neuropathy and the neuropathy induced by antiretroviral drugs such as stavudine, zalcitabine, and didanosine. The results of the present study suggest that acetyl-L-carnitine may also be effective for preventing or treating neuropathy induced by paclitaxel or cisplatin.

Bianchi G, et al. Symptomatic and neurophysiological responses of paclitaxel- or cisplatin-induced neuropathy to oral acetyl-L-carnitine. Eur J Cancer. 2005;41:1746-1750.