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The classic mechanism of acetaminophen hepatotoxicity is that its reactive metabolite, N-acetyl-p-benzoquinoneimine (NAPQI), depletes GSH and then covalently binds to proteins
Before evaluating any investigational compound, understanding baseline liver enzyme status establishes whether liver function is within normal parameters
101 This reduces iron-dependent lipid peroxidation and ferroptosis
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A preliminary randomised controlled trial to compare the effects of duloxetine and acetyl-l-carnitine on pain, depression, anxiety, and well-being in patients with fibromyalgia suggested that acetyl-l-carnitine was efficacious in improving depressive symptoms, pain, and quality of life [91]
