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[57] They found that the cause was likely a low availability of precursors of carnitine biosynthesis (specifically, trimethyllysine and gamma-butyrobetaine, associated with the amino acid lysine and its role in the synthesis of carnitine)

They also ended with actionable steps which reinforced learning

Vanella A, Russo A, Acquaviva R, Campisi A, Di Giacomo C, Sorrenti V, Barcellona ML

Although ALCAR is not a first-line treatment for severe depression, it should be kept in mind for patients with dysthymia, possible cerebrovascular insufficiency, fibromyalgia, or an inability to tolerate prescription antidepressant medications