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Differential roles of the ubiquitin proteasome system and autophagy in the clearance of soluble and aggregated TDP-43 species

A 2007 double-blind, multicenter trial (n=102) showed ALC 1,500 mg/day significantly improved tender point count, total myalgic score, depression, and musculoskeletal pain compared to placebo.[9] A 2015 RCT found ALC 1,500 mg/day comparable to duloxetine 60 mg/day for pain and depression.[8] Most notably, a 2023 RCT demonstrated that adding PEA 1,200 mg/day + ALC 2,000 mg/day to ongoing duloxetine + pregabalin therapy produced significantly greater improvements in Widespread Pain Index, FIQR, and FASmod scores.[7] Role in Treatment: ALC can be used as monotherapy or adjunctive therapy in fibromyalgia

Rodent protocols use 50100 higher per-kilogram doses because metabolic rate, receptor density, and clearance kinetics differ across species

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