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Lokrantz and coworkers [72] recently reported the case of an old woman taking VPA monotherapy for her partial epilepsy in whom a typical hyperammonaemic encephalopathy was precipitated by treatment for a urinary tract infection with pivmecillinam an antibiotic known to decrease the serum concentration of carnitine

This restoration of the energy pipeline is absolutely critical for tissues with the highest metabolic demands, particularly the skeletal muscles and the myocardium

Changes in the blood concentrations of specific acylcarnitines in subjects with either subjective memory complaints, mild cognitive impairment, or Alzheimer's disease, compared to cognitively healthy peers may reflect changes in the transport of fatty acids into the mitochondria and/or impairments in energy production

Deuteration has gained attention because of its potential to affect the pharmacokinetic and metabolic profiles of drugs [1]

10.1136/bmj.n2321 [DOI] [PMC free article] [PubMed] [Google Scholar] 46.Jevsevar DS