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Wang, K., Xie, W., & Harcum, S

The acetyl group from acetyl-l-carnitine is also responsible for the production of acetylcholine, an important neurotransmitter for optimal mental functioning.* Uses For Acetyl-l-Carnitine Support For Cognitive Function, Memory, And Emotional Well-Being: The efficacy of long-term acetyl-l-carnitine supplementation was determined in a double blind, placebo-controlled, randomized trial involving 130 elderly individuals for a one-year period

It is not the same as sildenafil, because it acts on the brain, not the blood vessels