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N Engl J Med 360:15181525 Wardlaw DF, Gordon ME, Kessel MJ (2002) Perspectives in Nutrition, 5th edn

The highest level of acetylcarnitine incorporation into brain lipids is observed 1 h after injection and then gradually decreases, suggesting that the metabolic capacity to utilize the acute increase in acetyl groups may be limited and that the excess of acetyl groups is then rapidly incorporated into lipids

Maccari F, Arseni A, Chiodi P, Ramacci MT, Angelucci L: Levels of carnitines in brain and other tissues of rats of different ages: effect of acetyl-L-carnitine administration

Acute manifestations include hypoxia, frostbite, and psychiatric symptoms