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2017 meta-analysis: A systematic review and meta-analysis of nine randomized controlled trials showed that ALCAR supplementation significantly decreased depressive symptoms compared to placebo (standardized mean difference 1.10, 95% CI 1.65 to 0.56), with effects comparable to established antidepressants like fluoxetine, particularly in older adults or those with treatment-resistant depression [5][30]

Notably, combination treatment with lower dose of metformin (0.1 mmol/L) and liraglutide (3 nmol/L) had a significant protective effect on the PA-induced upregulation of ROS production and reduction of NO level and p-eNOS protein level (Fig