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Since the most common amitriptyline side effect is represented by sleepiness, the drug should be administered at bedtime

Autonomic and Neuroendocrine Dysfunctions Clinical manifestations of the autonomic nervous system (ANS) activation are dominant clinical features of CVS during both prodromal and acute phase

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doi: 10.1016/j.eplepsyres.2011.09.021

The acetyl group in ALCAR solves this problem, creating a form that readily enters brain tissue to support both mental and physical energy at the cellular level