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In addition to TTM, promising preliminary results suggest the need for controlled studies in other grooming disorders, including nail biting and skin picking.39,41 A case report was published regarding an individual with both TTM and nail biting behaviours, in whom nail biting ceased following 9 weeks of NAC treatment.39 The participant relapsed after a hiatus in treatment, but recommencement of NAC resulted in a remission of symptoms.39 A serendipitous finding of the benefit of NAC treatment in the reduction of nail biting in a study primarily investigating NAC (2000 mg/d) in the treatment of mood disorders has been reported.41 Three participants taking NAC reported significant reductions in nail biting during the 6-month course of treatment

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This phenomenon is increasingly observed in various ion channels, including voltage-gated Ca 2+ channels and ATP-sensitive K + channels (K ATP ) (Tang et al., 2011

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Check with your doctor as soon as possible if any of the following side effects occur while taking levocarnitine: More common side effects Less common side effects fast heartbeat fever Rare side effects seizures Other side effects of levocarnitine Some side effects of levocarnitine may occur that usually do not need medical attention