{"id":"d23dcb1c-084a-5ad1-a4c4-de4b47d5fbc6","stable_key":"e3f6ce02-0bd7-5103-acc1-68503ab6751b:psychosis-case","predicate":"reported_relationship","statement":"Psychosis occurred five days after ALCAR was started in a published bipolar-disorder case report.","claim_class":"observational","status":"source_recorded","evidence_grade":"ungraded","direction":"neutral","is_public":true,"mechanism_event_id":"dff91c07-3867-5168-ad2f-1374c31c0cef","mechanism_event_label":"Psychosis occurred five days after ALCAR was started in a published bipolar-disorder case report.","subject":{"id":"5ce394a9-6ec6-56dd-866f-37d85c0556e4","slug":"acetylcarnitine","display_name":"Acetyl-L-carnitine","entity_type_key":"small_molecule"},"object":{"id":"2eec7630-6e70-568b-b879-762cce640d38","slug":"human-alcar-associated-psychosis","display_name":"Reported psychosis after starting ALCAR","entity_type_key":"cellular_process"},"evidence_count":1,"mechanism_event":{"id":"dff91c07-3867-5168-ad2f-1374c31c0cef","stable_key":"e3f6ce02-0bd7-5103-acc1-68503ab6751b:psychosis-case-event","event_type":"experimental_observation","label":"Psychosis occurred five days after ALCAR was started in a published bipolar-disorder case report.","description":"### psychosis-case\n\nPsychosis occurred five days after ALCAR was started in a published bipolar-disorder case report.\nTemporal association and author attribution are recorded. No rechallenge, incidence estimate or proven dopamine-mediated cause is established.\nModel and exposure: 52-year-old man; ALCAR 500 mg/day alongside newly added vitamins C/E, ongoing lithium and citalopram; prior recurrent illness.\nLimitations: Single confounded case; this is a signal, not a quantified risk or proof that ALCAR invariably triggers psychosis.\nReference: Psychosis Precipitated by Acetyl-l-Carnitine in a Patient With Bipolar Disorder. | 2007 | https://pubmed.ncbi.nlm.nih.gov/17599177/ | https://pmc.ncbi.nlm.nih.gov/articles/PMC1894836/ | https://doi.org/10.4088/pcc.v09n0114d | Access: Primary full text: relevant Results/Methods and figure descriptions reviewed; supplements only where explicitly stated.","status":"provisional","compartment":null,"participants":[{"entity":{"id":"5ce394a9-6ec6-56dd-866f-37d85c0556e4","slug":"acetylcarnitine","display_name":"Acetyl-L-carnitine","entity_type_key":"small_molecule"},"role":"recorded factor","stoichiometry":null,"state_label":"as reported","sequence_order":0,"notes":""},{"entity":{"id":"2eec7630-6e70-568b-b879-762cce640d38","slug":"human-alcar-associated-psychosis","display_name":"Reported psychosis after starting ALCAR","entity_type_key":"cellular_process"},"role":"measured outcome","stoichiometry":null,"state_label":"not_reported","sequence_order":1,"notes":""},{"entity":{"id":"da1a7137-08f2-5a36-8bb6-377fbd32e327","slug":"vitamin-c","display_name":"Vitamin C","entity_type_key":"chemical_species"},"role":"co-started supplement","stoichiometry":null,"state_label":"","sequence_order":2,"notes":""},{"entity":{"id":"e67a0437-6900-5f53-8b03-c0a7ad6d92b6","slug":"vitamin-e","display_name":"Vitamin E","entity_type_key":"chemical_species"},"role":"co-started supplement","stoichiometry":null,"state_label":"","sequence_order":3,"notes":""}]},"contexts":[{"dimension":"evidence_access","value_text":"Primary full text: relevant Results/Methods and figure descriptions reviewed; supplements only where explicitly stated.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"experimental_model","value_text":"52-year-old man; ALCAR 500 mg/day alongside newly added vitamins C/E, ongoing lithium and citalopram; prior recurrent illness.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"interpretation_status","value_text":"Source-derived curation with stated access limits; ungraded, not independent replication.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"limitations","value_text":"Single confounded case; this is a signal, not a quantified risk or proof that ALCAR invariably triggers psychosis.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"nutrient_topic","value_text":"Acetyl-L-carnitine collection; exact intervention and molecular form govern interpretation.","comparator":null,"unit":null,"notes":"","entity":{"slug":"acetylcarnitine","display_name":"Acetyl-L-carnitine","entity_type_key":"small_molecule"}},{"dimension":"plain_language","value_text":"Psychosis occurred five days after ALCAR was started in a published bipolar-disorder case report.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"primary_references","value_text":"Psychosis Precipitated by Acetyl-l-Carnitine in a Patient With Bipolar Disorder. | https://pubmed.ncbi.nlm.nih.gov/17599177/ | https://pmc.ncbi.nlm.nih.gov/articles/PMC1894836/ | https://doi.org/10.4088/pcc.v09n0114d","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"source_locator","value_text":"Reviewed reference psychosis-case; Temporal association and author attribution are recorded. No rechallenge, incidence estimate or proven dopamine-mediated cause is established.","comparator":null,"unit":null,"notes":"","entity":null}],"evidence":[{"id":"9c406e13-c955-5026-bef5-078d42abd0aa","evidence_kind":"source_excerpt","locator":"Lines 611-617","start_line":611,"end_line":617,"excerpt":"### psychosis-case\n\nPsychosis occurred five days after ALCAR was started in a published bipolar-disorder case report.\nTemporal association and author attribution are recorded. No rechallenge, incidence estimate or proven dopamine-mediated cause is established.\nModel and exposure: 52-year-old man; ALCAR 500 mg/day alongside newly added vitamins C/E, ongoing lithium and citalopram; prior recurrent illness.\nLimitations: Single confounded case; this is a signal, not a quantified risk or proof that ALCAR invariably triggers psychosis.\nReference: Psychosis Precipitated by Acetyl-l-Carnitine in a Patient With Bipolar Disorder. | 2007 | https://pubmed.ncbi.nlm.nih.gov/17599177/ | https://pmc.ncbi.nlm.nih.gov/articles/PMC1894836/ | https://doi.org/10.4088/pcc.v09n0114d | Access: Primary full text: relevant Results/Methods and figure descriptions reviewed; supplements only where explicitly stated.","model_system":"52-year-old man; ALCAR 500 mg/day alongside newly added vitamins C/E, ongoing lithium and citalopram; prior recurrent illness.","directness":"reported_statement","verification_status":"source_recorded","notes":"Original paraphrase in the retained reviewed reference, not a verbatim primary-paper quotation. Access level is explicit.","relationship":"supports","weight":1.0,"link_notes":"","source":{"id":"2588f904-245a-597a-8a12-65118013fb90","stable_key":"import-e3f6ce02-0bd7-5103-acc1-68503ab6751b","title":"Acetyl-L-carnitine: detailed mechanisms of action (reviewed 6 October 2026)","document_type":"imported_text","citation_label":"AI-assisted original review of primary studies and clearly identified official records. Exact primary access is stated; no independent replication is claimed.","file_path":"","sha256":"84cc82d6fbb0fd5d73c4ce779e9f88e7f0184ba2d29b18ad0f153815380f2975","revision_id":"dac7a950-dbe5-5c7a-9c70-2ea711d5c71a","review_status":"source_recorded","notes":""}}],"relations":[],"conflicts":[],"corrections":[],"research":null}