The site of the Media Sphera Publishers contains materials intended solely for healthcare professionals.
By closing this message, you confirm that you are a certified medical professional or a student of a medical educational institution.

Login
EN
+7 (495) 482-4118
+7 (495) 482-4329
+8 800 250-18-12
  • (toll-free number for subscriptions)
    Mon-Fri from 10 a.m. to 6 p.m.

  • © 1998-2026
+7 (495) 482-43-29
EN
All journals
Journal
Year
Year
Search result: 0

Sokolova L.P.

Pirogov Russian National Research Medical University;
Clinical Hospital No. 1 UD of the President of the Russian Federation

Starykh E.V.

Pirogov Russian National Research Medical University

Asthenic syndrome in general therapeutic practice

Authors:

Sokolova L.P., Starykh E.V.

More about the authors

Journal: S.S. Korsakov Journal of Neurology and Psychiatry. 2022;122(4): 44‑51

DOI: 10.17116/jnevro202212204144

Read: 7702 times

Contact the author
Table of contents

ASTHENIC SYNDROME IN GENERAL THERAPEUTIC PRACTICE
ASTHENIC SYNDROME IN GENERAL THERAPEUTIC PRACTICE

To cite this article:

Sokolova LP, Starykh EV. Asthenic syndrome in general therapeutic practice. S.S. Korsakov Journal of Neurology and Psychiatry. 2022;122(4):44‑51. (In Russ.)
https://doi.org/10.17116/jnevro202212204144

Подписка 2026 Журнал неврологии и психиатрии им. С.С. Корсакова (S.S. Korsakov Journal of Neurology and Psychiatry)
МСФ на ЯМ
Использование инфографики авторами научных работ
Close metadata
Recommended articles:
Resu­lts of the obse­rvational program CITO­TREK (use of the drug CITO­flavin in Tablets) in patients with tension headaches against the backgRound of asthenic syndromE taKing into account como­rbidity. S.S. Korsakov Journal of Neurology and Psychiatry. 2025;(10):104-112
Cogi­tum in the treatment of mental diso­rders in childhood. S.S. Korsakov Journal of Neurology and Psychiatry. 2025;(10-2):88-95
Atte­ntion defi­cit diso­rder in adults: features of social and family rela­tionships. S.S. Korsakov Journal of Neurology and Psychiatry. 2026;(1):13-18
Mito­chondrial cyto­protectors in complex therapy of chro­nic heart failure in patients with meta­bolic syndrome or type 2 diabetes mellitus: suba­nalysis of the INDI­KOR study. Russian Journal of Cardiology and Cardiovascular Surgery. 2025;(5):566-576
Study of the effe­ctiveness of the drug Elca­rnitine in the correction of increased variability of arte­rial pressure in patients with hype­rtensive disease and cognitive dysfunction. Russian Journal of Preventive Medi­cine. 2025;(10):88-92
Abstract:

The presented material indicates that asthenia can be considered as a universal protective mechanism accompanying various psychophysiological processes and somatic diseases, which are based on the mechanisms of energy deficiency. The article discusses different etiological factors and clinical forms of asthenic syndrome (AS) depending on the causes of its development. The research specifies the main effects of carnitine, according to which a conclusion is made about the possibility of use of L-carnitine preparations for the correction of AS in mono- and polytherapy.

Keywords:

Keyword: asthenia
energy deficiency
L-carnitine

Authors:

Sokolova L.P.

Pirogov Russian National Research Medical University;
Clinical Hospital No. 1 UD of the President of the Russian Federation

Starykh E.V.

Pirogov Russian National Research Medical University

Received:

26.01.2022

Accepted:

17.03.2022

Close metadata

References:

  1. Lebedev MA, Palatov SYu, Kovrov GV, et al. Asthenia: symptom, syndrome, disease. Effective Pharmacotherapy. Neurology and Psychiatry. 2014;1:30-38. (In Russ.).
  2. Dyukova GM. Asthenic syndrome: problems of diagnosis and therapy. Effective pharmacotherapy. Neurology and Psychiatry. 2012;1:16-22. (In Russ.).
  3. Shakirova IN, Djukova GM. Astenija — mezhdisciplinarnaja problema. Trudnyj Pacient. 2012;5:14-16. (In Russ.).
  4. Hadjimichael O, Vollmer T, Oleen-Burkey M. North American Research Committee on Multiple Sclerosis. Fatigue characteristics in multiplesclerosis: the North American Research Committee on Multiple Sclerosis (NARCOMS) survey. Health Qual Life Outcomes. 2008;6:100-110. 
  5. Jasiukeviciene L, Vasiliauskas D, Kavoliniene A, et al. Evaluation of a chronic fatigue in patients with chronic heart failure. Medicina (Kaunas). 2008;44(5):366-372. 
  6. Watanabe N, Stewart R, Jenkins R, et al. The epidemiology of chronic fatigue, physical illness, and symptoms of common mental disorders: a cross-sectional survey from the British National Survey of Psychiatric Morbidity. J Psychosom Res. 2008;64(4):357-362. 
  7. Kulikovsky VV. Clinical and pathogenetic aspects of asthenic syndrome of psychogenic and somatogenic genesis: Dis. ... d-ra. med. nauk. M. 1994;482. (In Russ.).
  8. Rodshtat IV. Questions of the clinic and pathogenesis of asthenic conditions (neurological and psychological analysis): Dis. ... kand. med. nauk. M. 1967;265. (In Russ.).
  9. De Lange FP, Kalkman JS, Bleijenberg G. Neural correlates of the chronic fatigue syndrome — an fMRI study. Brain. 2004;127(9):1948-1957.
  10. Nazarenko GI, Kishkun AA. Clinical evaluation of laboratory results. M.: Medicine; 2000;544. (In Russ.).
  11. Vanuxem P. Ammonium et Fatigue, in «Asthenics Physiques». Ed. by Serratrice G. Paris. 1990;49-57. 
  12. Scott LV, Dinan TG. The neuroendocrinology of chronic fatique syndrome: focus on the hypothalamic-pituitary-adrenal axis. Funct Neurol. 1999;14(1):3-11. 
  13. Sizova ZhM, Shikh EV, Makhova AA. Significance of l-carnitine in internal medicine. Ter Archive. 2019;91(1):114-120. (In Russ.). https://doi.org/10.26442/00403660.2019.01.000040
  14. Avedisova AS. Antiasthenic drugs as first choice therapy for asthenic disorders. RMJ. 2004;12:22:1290-1292. (In Russ.).
  15. Afari N, Buchwald D. Chronic fatigue syndrome: A review. Am J Psychiatry. 2003;160:2:221-236. 
  16. Kotova OV, Akarachkova ES. Asthenic syndrome in the practice of a neurologist and a family doctor. RMJ. 2016;13:824-829. (In Russ.).
  17. Fukuda K, Straus SE, Hickie I, et al. The chronic fatigue syndrome: a comprehensive approach to its definition and study. Ann Intern Med. 1994;121:953-959. 
  18. Marilov VV. General psychopathology. M.: Academy; 2002;224. (In Russ.).
  19. Committee on Sleep Medicine and Research, Board on Health Sciences Policy. Sleep disorders and sleep deprivation: an unmet public health problem. — Washington (DC): National Academies Press (US); 2006;425. 
  20. Stal SM. Fundamentals of psychopharmacology. Theory and practice. M.: GEOTAR-Media; 2020;296. (In Russ.).
  21. Karvasarsky BD. Neuroses. M.: Medicine; 1990;448. (In Russ.).
  22. Gilyarovsky VA. Psychiatry. M.—L.: Biomedgiz; 1935. (In Russ.).
  23. Nuller YuL, Tsirkin SYu. International classification of diseases. 10 revision. Psychiatric systematics. M. 2005;214. (In Russ.).
  24. Shukin IA, Lebedeva AV, Burd GS, et. al. Chronic cerebral ischemia: syndromological approaches to therapy. Neurology. Rheumatology. 2015;2:3-10. (In Russ.).
  25. Garg P, Arora U, Kumar A, Wig N. The «post-COVID» syndrome: How deep is the damage? J Med Virol. 2021;93(2):673-674.  https://doi.org/10.1002/jmv.26465
  26. Lopez-Leon S, Wegman-Ostrosky T, Perelman C, et al. More than 50 Long-term effects of COVID-19: a systematic review and meta-analysis. medRxiv [Preprint] 2021;2021.01.27.21250617. https://doi.org/10.1101/2021.01.27.21250617
  27. Townsend L, Dyer AH, Jones K, et al. Persistent fatigue following SARS-CoV-2 infection is common and of severity of initial infection. PLoS One 2020;15(11):e0240784. https://doi.org/10.1371/journal.pone.0240784
  28. Ostroumova TM, Ostroumova OD, Ebzeeva EYu, Arablinsky NA. Asthenia and cognitive impairment in the presence of COVID-19. Possibilities of the drug Actovegin in their correction. Neurology. Clinical Analysis. 2021;1:28-34. (In Russ.). https://doi.org/10.47407/kr2021.2.1.00035
  29. Kamchatnov P.R., Solov’eva E.Yu., Khasanova D.R., Fateeva V.V. Asthenic and cognitive disorders after the COVID-19 infection. Russ Medical Inquiry. 2021;5(10):636-641. (In Russ.). https://doi.org/10.32364/2587-6821-2021-5-10-636-641
  30. Cox T, Griffits A. (ed.) The Burnout Companion to Study and Practice. A Critical Analysis, LA, 1998;344. 
  31. Evans A. Dialysis-related carnitine disorder and levocarnitine pharmacology. Am J Kidney Dis. 2003;41(suppl 4):263-268. 
  32. Schreiber B, Lewis V. Management of carnitine deficiency in ESRD patients undergoing dialysis. Dialysis & Transplantation. 2001;30:207-212. 
  33. Rebouche CJ. Carnitine. In: Shils ME, Shike M, Ross AC, Caballero B, Cousins RJ, eds. Modern Nutrition in Health and Disease. 10th ed. Philadelphia: Lippincott, Williams & Wilkins; 2006;537-544. 
  34. Hiatt WR, Regensteiner JG, Wolfel E, et al. Carnitine and acylcarnitine metabolism during exercise in humans. Dependence on skeletal muscle metabolic state. J Clin Invest. 1989;84:1167-1173.
  35. Lopaschuk GD, Ussher JR, Folmes C, et al. Myocardial fatty acid metabolism in health and disease. Physiol Rev. 2010;90:1:207-258. 
  36. Astashkin EI, Glezer MG. The role of L-carnitine in the energetic metabolism of cardiomyocytes and treatment of cardio-vascular diseases. Kardiologiya i Serdechno-Sosudistaya Khirurgiya. 2012;5(6):58-65. (In Russ.).
  37. Palacios HH, Yendluri BB, Parvathaneni K, et al. Mitochondrionspecific antioxidants as drug treatments for Alzheimer disease. CNS Neurol Disord Drug Targets. 2011;10(2):149-162.  https://doi.org/10.2174/187152711794480474
  38. Malaguarnera M, Gargante MP, Cristaldi E, et al. Acetyl L-carnitine (ALC) treatment in elderly patients with fatigue. Arch Gerontol Geriatr. 2008;46(2):181-190.  https://doi.org/10.1016/j.archger.2007.03.012
  39. Chiechio S, Canonico PL, Grilli M. L-Acetylcarnitine: a mechanistically distinctive and potentially rapid-acting antidepressant drug. Int J Mol Sci. 2018;19(1):11-18.  https://doi.org/10.3390/ijms19010011
  40. Malaguarnera M. Acetyl L-carnitine (ALC) treatment in elderly patients with fatigue. Arch Gerontol Geriatr. 2008;46(2):181-190. 
  41. Pistone G, Marino A, Leotta C, et al. Levocarnitine administration in elderly subjects with rapid muscle fatigue. Drugs Aging. 2003;20:761-767. 
  42. Neri S, Pistone G, Saraceno, B, et al. L-Carnitine decreases severity and type of fatigue induced by interferon-alpha in the treatment of patients with hepatitis C. Neuropsychobiology. 2003;47:94-97. 
  43. Liu J, Head E, Gharib AM, et al. Memory loss in old rats is associated with brain mitochondrial decay and RNA/DNA oxidation partial reversal by feeding acetyl-L-carnitine and/or R-lipoic acid. Proc Natl Acad Sci USA. 2002;99:2356-2361.
  44. Montgomery SA, Thal LJ, Amrein R. Meta-analysis of double blind randomized controlled clinical trials of acetyl-L-carnitine versus placebo in the treatment of mild cognitive impairment and mild Alzheimer’s disease. Int Clin Psychopharmacol. 2003;18:61-71. 
  45. Golovkin VA, Zuev AA, Privalova MO, et al. Cognitive and cardiorespiratory dysfunction in encephalopathy with cardiocerebral syndrome. Vrach. 2018;29(4):51-53. (In Russ.). https://doi.org/10.29296/25877305-2018-04-09
  46. Mozheiko ME, Bushueva EV, Potanina MV, et al. Possibilities of pharmaceutical treatment of cardiogenic encephalopathy with the use of metabolic action levocarnitine in patients with ischemic heart disease and congestive heart failure. Consilium Medicum. 2019;21(12):106-111. (In Russ.).
  47. Malaguarnera M, Cammalleri L, Gargante M, et al. L-carnitine treatment reduces severity of physical and mental fatigue and increases cognitive functions in centenarians: a randomized and controlled clinical trial. Am J Clin Nutr. 2007;86:1738-1744.
  48. Tomassini V, Pozzilli C, Onesti E, et al. Comparison of the effects of acetyl L-carnitine and amantadine for the treatment of fatigue in multiple sclerosis: results of a pilot, randomised, double-blind, crossover trial. J Neurol Sci. 2004;218:103-108. 
  49. Bersani G, Meco G, Denaro A, et al. L-acetylcarnitine in dysthymic disorder in elderly patients: a double-blind, multicenter, controlled randomized study vs. fluoxetine. Eur Neuropsychopharmacol. 2013;23(10):1219-1225.
  50. Gavrilova SI, Kalyn IaB, Safarova TP, et al. Optimization of the efficacy of antidepressant therapy in patients of a psychiatric unit. Zhurnal Nevrologii i Psikhiatrii im. S.S. Korsakova. 2015;115(6):24-32. (In Russ.). https://doi.org/10.17116/jnevro20151156124-32
  51. Lau T, Bigio B, Zelli D, et al. Stress-induced structural plasticity of medial amygdala stellate neurons and prevention by antidepressant. Mol Psychiatry. 2017;22(2):227-234.  https://doi.org/10.1038/mp.2016.68
  52. Nasca C, Bigio B, Lee SL, et al. Acetyl-L-carnitine deficiency in patients with major depressive disorder. Proc Natl Acad Sci USA. 2018;115(34):8627-8632. https://doi.org/10.1073/pnas.1801609115
  53. Nasca C, Xenos D, Barone Y, L-acetylcarnitine causes rapid antidepressant effects epigenetic induction of mGlu2 receptors. Proc Natl Acad Sci USA. 2013;110(12):4804-4809. https://doi.org/10.1073/pnas.1216100110
  54. Safarova TP, Gavrilova SI, Yakovleva OB, et al. Augmentation of Carnicetin in the Treatment of Late Depression. Journal of Neurology and Psychiatry named after S.S. Korsakov. 2019;119(5):65-75. (In Russ.). https://doi.org/10.17116/jnevro201911905165
  55. Duma SN, Lisichenko OV, Lukyanova GV. Psychovegetative, asthenic and cognitive impairment in tissue dysplasia: choice of optimal therapy. Pharmateca. 2012;7:1-5. (In Russ.).
  56. Brass EP. Pivalate-generating prodrugs and carnitine homeostasis in man. Pharmacol Rev. 2002;54:4:589-598. 
  57. Flanagan JL, Simmons PA, Vehige J, et al. Role of carnitine in disease. Nutr Metab (Lond). 2010;7:30-43.  https://doi.org/10.1186/1743-7075-7-30
  58. Konyavko M, Adachi S. Regulation of the activity of caspases by L—carnitine and palmitoylcarnitine. FEBS Lett. 2000;478:19-25. 
  59. Astashkin EI, Gleser MG, Orekhova NS, et al. Influence of l-carnitine on reactive oxygen species production by blood phagocytes in postinfarction cardiosclerosis patients. Cardiovascular Therapy and Prevention. 2016;15(5):28-32. (In Russ.). https://doi.org/10.15829/1728-8800-2016-5-28-32
  60. Astashkin EI, Glezer MG. Effect of l-carnitine on oxydative stress at cardiovascular diseases. Medical Council. 2016;10:94-100. (In Russ.). https://doi.org/10.21518/2079-701X-2016-10-104-110
  61. Gusev EI, Kuzin VM, Kolesnikova TN, et al. Carnitine is a leading factor in the regeneration of nervous tissue. Med. Information Bulletin. 1999;2:11-23. (In Russ.).
  62. Chichanovskaya LV, Bakhareva ON, Sorokina KB. A study of the efficacy and safety of l-carnitine in patients with ischemic stroke in the early rehabilitation period. Journal of Neurology and Psychiatry named after S.S. Korsakov. 2017;117:2:65-69. (In Russ.). https://doi.org/10.17116/jnevro201711712265-69
  63. Bodykhov MK, Stakhovskaya LV, Salimov KA, I SC. Evaluation of the safety and efficacy of the drug «Elkar» (levocarnitine) in patients in the acute period of ischemic stroke in the carotid system. RMZh. Neurology. 2011;11:3-6. (In Russ.).
  64. Surai PF. Antioxidant action of carnitine: molecular mechanisms and practical applications EC. Veterinary Science. 2015;2(1):66-84. 
  65. Gülçin I. Antioxidant activities of L-carnitine. Life Sci. 2006;78(8):803-811. 
  66. Solarska K, Lewińska A, Karowicz-Bilińska A, Bartosz Gr. The antioxidant properties of carnitine in vitro. Cell Mol Biol Lett. 2010;15(1):90-97. 
  67. Anderson EJ, Kypson AP, Rodriguez E, et al. Substrate-specific derangements i mitochondrial metabolism and redox balance in the atrium of the type 2 diabetic human heart. JACC. 2009;54(20):1891-1898.
  68. Kolodziejczyk J, Saluk-Juszczak J, Wachowicz B. L-carnitine protects plasma components against oxidative alterations. Nutrition. 2011;27(6):693-699. 
  69. Vanella A, Russo A, Acquaviva R, et al. L-Propionyl-carnitine as superoxide scavenger, antioxidant, and DNA cleavage protector. Cell Biol Toxicol. 2000;16(2):99-104. 
  70. Pereverzev AP, Shevchenko DA, Filippova AV, et al. Levocarnitine for the treatment of polymorbid patients. Rational Pharmacotherapy in Cardiology. 2020;16(1):139-146. (In Russ.). https://doi.org/10.20996/1819-6446-2020-02-11
  71. Cipolla M, Nicoloff A, Rebello T, et al. Propionyl-L-carnitine dilates human subcutaneous arteries through an endothelium-dependent mechanism. J Vasc Surg. 1999;29(6):1097-10103. https://doi.org/10.1016/s0741-5214(99)70251-x
  72. Statsenko ME, Turkina SV. Possibilities of sequential levocarnitin and acetylcarnitin treatment in correcting cognitive deficiency in patients with cardiovascular diseases. Journal of Neurology and Psychiatry named after S.S. Korsakov. 2021;121(5):38-44. (In Russ.). https://doi.org/10.17116/jnevro202112105145
  73. Rizos I. Three year survival of patients with heart failure caused by dilated cardiomyopathy and L-carnitine administration. Am Heart J. 2000;139(2 Pt 3):120-123.  https://doi.org/10.1067/mhj.2000.103917
  74. Song X, Qu H, Yang Z, et al. Efficacy and Safety of L-Carnitine Treatment for Chronic Heart Failure: A Meta-Analysis of Randomized Controlled Trials. Biomed Res Int. 2017;2017:6274854. https://doi.org/10.1155/2017/6274854
  75. Ruggenenti P, Cattaneo D, Loriga G, et al. Ameliorating Hypertension and Insulin Resistance in Subjects at Increased Cardiovascular Risk Effects of Acetyl-L-Carnitine Therapy. Hypertension. 2009;54:567-574.  https://doi.org/10.1161/HYPERTENSIONAHA.109.132522
Contact the author
Email
Message
The publishing house "Media Sphere" does not provide treatment services, does not give recommendations on contacting medical institutions and specific specialists, on the prescription of medicines and dietary supplements.

Email Confirmation

An email was sent to test@gmail.com with a confirmation link. Follow the link from the letter to complete the registration on the site.

Email Confirmation

Contact us
If you have any questions, complaints or suggestions, please use this feedback form.
Email
Message
The publishing house "Media Sphere" does not provide treatment services, does not give recommendations on contacting medical institutions and specific specialists, on the prescription of medicines and dietary supplements.
Submit Application

You can become an author of one of our magazines, send a request and we will consider it in during the day.

Name
Phone
E-mail
Message
Login
Registration
E-mail
Password
Forgot Password?

Log in to the site using your account in one of the services

Password recovery
E-mail
Login
Register

We use cооkies to improve the performance of the site. By staying on our site, you agree to the terms of use of cооkies. To view our Privacy and Cookie Policy, please. click here.