L-acetylcarnitine or acet-L-carnitine, a compound, naturally produced by the body, is necessary for fatty-acid metabolism and energy production. It is often taken as a dietary supplement. The mechanisms of action of acetylcarnitine have not been fully elucidated, but it seems that the main role of acetylcarnitine is to donate an acetyl group during fatty acid metabolism to help transport fatty acids, such as acetyl CoA, into the mitochondrial matrix where fatty acid metabolism occurs. L-acetylcarnitine is an investigational drug, which is approved in some countries, for example in Italy for diabetic neuropathy. Phase IV of clinical trials have revealed, that it also effective agent to treat the Alzheimer's disease. In contrary, the efficacy of L-acetylcarnitine as a prophylaxis in migraine patients did not provide evidence of benefit for efficacy. Besides, Acetyl-L-carnitine was in clinical trial Phase III to investigate its efficacy in the treatment of peripheral sensory neuropathy that anti-cancer chemotherapeutics induce. Recently published article unexpectedly discovered that this drug increased chemotherapy-induced peripheral neuropathy in a randomized trial.

Methylcobalamin (also known as mecobalamin, MeCbl, or MeB12) is one of the two forms of biologically active vitamin B12. Methyl-B12 is the principal form of circulating vitamin B12, hence the form, which is transported into peripheral tissue. Methylcobalamin is absorbed by the intestine by a specific mechanism, which uses the intrinsic factor, and by a diffusion process in which approximately 1% of the ingested dose is absorbed. Cyanocobalamin and hydroxycobalamin are forms of the vitamin that require conversion to methylcobalamin. Methylcobalamin alone or in combination with others compound are used to treat different diseases. Being a component of CEREFOLIN NAC it is used to treat Alzheimer's dementia. As a part of METANX® tablets is used for the dietary management of endothelial dysfunction in patients with diabetic peripheral neuropathy. Methylcobalamin exerted therapeutic effects on neuropathic pain in diabetics, possibly through its neurosynthesis and neuroprotective actions. The possible mechanisms can be considered as follows. (1) Methylcobalamin improved nerve conduction velocity; (2) methylcobalamin promoted injured nerve regeneration, recovering the neuromuscular functions in peripheral hyperalgesia and allodynia; and (3) methylcobalamin inhibited the ectopic spontaneous discharges from peripheral primary sensory neurons in neuropathic pain states. Methylcobalamin is the only form that can cross the blood-brain barrier and so can directly protect brain cells from degeneration. While crossing the barrier, it also stimulates production of serotonin, a chemical neurotransmitter responsible for elevated mood; research where Alzheimer’s patients were administered methylcobalamin showcased improvements in memory, communication skills, and emotions. It also helps form the myelin sheath, the insular coating around nerve cells that allow for electrical impulses to travel through the nervous system more efficiently.

L-acetylcarnitine or acet-L-carnitine, a compound, naturally produced by the body, is necessary for fatty-acid metabolism and energy production. It is often taken as a dietary supplement. The mechanisms of action of acetylcarnitine have not been fully elucidated, but it seems that the main role of acetylcarnitine is to donate an acetyl group during fatty acid metabolism to help transport fatty acids, such as acetyl CoA, into the mitochondrial matrix where fatty acid metabolism occurs. L-acetylcarnitine is an investigational drug, which is approved in some countries, for example in Italy for diabetic neuropathy. Phase IV of clinical trials have revealed, that it also effective agent to treat the Alzheimer's disease. In contrary, the efficacy of L-acetylcarnitine as a prophylaxis in migraine patients did not provide evidence of benefit for efficacy. Besides, Acetyl-L-carnitine was in clinical trial Phase III to investigate its efficacy in the treatment of peripheral sensory neuropathy that anti-cancer chemotherapeutics induce. Recently published article unexpectedly discovered that this drug increased chemotherapy-induced peripheral neuropathy in a randomized trial.