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Treatments and drugs
By Mayo Clinic staffBecause there's no reversing the course of amyotrophic lateral sclerosis, treatments mainly involve efforts to slow the progression of symptoms and make you more comfortable and independent.
Medications
The drug riluzole (Rilutek) is the first and only medication approved by the Food and Drug Administration for slowing ALS. The drug appears to slow the disease's progression in some people, perhaps by reducing levels of glutamate — a chemical messenger in the brain.
Your doctor may also prescribe medications to provide relief from:
- Muscle cramps
- Constipation
- Fatigue
- Excessive salivation
- Excessive phlegm
- Pain
- Depression
Therapy
- Physical therapy. A physical therapist can recommend low-impact exercises to maintain your muscle strength and range of motion as long as possible, helping you preserve a sense of independence.
- Occupational therapy. An occupational therapist can help you become accustomed to a brace, walker or wheelchair and may be able to suggest devices such as ramps that make it easier for you to get around.
- Speech therapy. Because ALS affects the muscles you use to speak, communication becomes an issue as the disease progresses. A speech therapist can help teach techniques to make your speech more clearly understood. Later in the disease, a speech therapist can recommend devices such as speech synthesizers and computers that may help you communicate.
- Amyotrophic lateral sclerosis fact sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/amyotrophiclateralsclerosis/detail_amyotrophiclateralsclerosis.htm. Accessed Sept. 18, 2008.
- Elman LB, et al. Clinical features of amyotrophic lateral sclerosis. http://www.uptodate.com/home/index.html. Accessed Sept. 18, 2008.
- Maragakis NJ, et al. Epidemiology and pathogenesis of amyotrophic lateral sclerosis. http://www.uptodate.com/home/index.html. Accessed Sept. 18, 2008.
- McCluskey L. Familial amyotrophic lateral sclerosis. http://www.uptodate.com/home/index.html. Accessed Sept. 18, 2008.
- Neurological diagnostic tests and procedures. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/misc/diagnostic_tests.htm. Accessed Sept. 19, 2008.
- ALS in the military: Unexpected consequences of military service. ALS Association. http://www.alsa.org/files/pdf/als_military_paper.pdf. Accessed Sept. 19, 2008.
- Elman LB, et al. Diagnosis of amyotrophic lateral sclerosis. http://www.uptodate.com/home/index.html. Accessed Sept. 19, 2008.
- Galvez-Jimenez N, et al. Symptom-based management of amyotrophic lateral sclerosis. http://www.uptodate.com/home/index.html. Accessed Sept. 19, 2008.
- Choudry RB, et al. Pharmacologic treatment of amyotrophic lateral sclerosis. http://www.uptodate.com/home/index.html. Accessed Sept. 19, 2008.
- Why is exercise important? In: Everyday Life With ALS: A Practical Guide. Muscular Dystrophy Association. http://www.als-mda.org/publications/everydaylifeals/ch8/. Accessed Sept. 19, 2008.
- Radunovic A, et al. Clinical care of patients with amyotrophic lateral sclerosis. Lancet Neurology. 2007;6(10):913-925.
- Lyon M. Reasons for living with ALS. ALS Association. http://www.alsa.org/patient/living.cfm?CFID=1025297&CFTOKEN=f8c064e9dbbd397-7B4C955C-188B-2E62-8049290070F4DFA9. Accessed Sept. 19, 2008.
- Good practice in the management of amyotrophic lateral sclerosis: Clinical guidelines. An evidence-based review with good practice points. Umea, Sweden: EALSC Working Group. Amyotrophic Lateral Sclerosis. 2007;8:195-213.
- Crum BA (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 21, 2008.
