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Research shows that L-Carnitine supplementation can increase fat oxidation in individuals who exercise regularly

Consideration should be given to changing the therapeutic regimen, including possibly discontinuing the medication, in patients whose depression is persistently worse, or who are experiencing emergent suicidality or symptoms that might be precursors to worsening depression or suicidality, especially if these symptoms are severe, abrupt in onset, or were not part of the patient's presenting symptoms

doi: 10.1016/b978-0-12-420117-0.00008-6 131 HasegawaYTakanoTMiyauchiAMatsuzukaFYoshidaHKumaKet al

It is also available as a prescription injection and in over-the-counter bulk powder formulations

242 PKC activation enhances excitatory currents in the dorsal horn and trigeminal neurons, contributing to nociceptive hypersensitivity in DPN