Health A-Z

Medical Content Created by the Faculty of the
Harvard Medical School

Amyotrophic Lateral Sclerosis (ALS)

Treatment

Although there is no cure for ALS, new treatments are under investigation. Riluzole (Rilutek) is the only drug approved by the U.S. Food and Drug Administration (FDA) for ALS, and it has been able to prolong survival in some people. Other treatments under study include a variety of growth factors that might stimulate nerve recovery, lithium, antibiotics and medicines that alter the immune system. So far, however, results have been disappointing. Animal studies have raised hopes about other therapies that might improve nerve and muscle function in people with ALS. These therapies include creatine, vitamin E and celecoxib, but clinical trials have found little or no evidence of effectiveness in humans. The use of stem cells to replace failing cells in the body offers new hope but definitive trials have not yet been reported. Many active clinical trials offer patients the chance to participate in the development of new therapies.

Although there is no cure available for ALS, a number of medications may be helpful for symptoms that may accompany the disease. For example, pain medications and muscle relaxants may help with painful muscle spasticity.

To help manage the symptoms of ALS, mechanical devices, such as dressing aids and special utensils for eating, are available to make self-care easier. A cane or walker also may be helpful for patients who have difficulty walking. Patients should consider the option of using a mechanical respirator if they become unable to breathe on their own. Although artificial ventilation can help some patients survive for years, many patients choose not to be kept alive in a state of total paralysis, unable to communicate except with eye movements. Patients with ALS should discuss this issue with their doctors early in the illness, so that the important and difficult decisions about emergency resuscitation can be made according to the patient's wishes in the event of life-threatening breathing problems.

Emotional support is crucial. Although much of this support can be provided by the patient's friends and family, a qualified counselor or psychotherapist also can be a valuable asset.

Although there is no cure for ALS, new treatments are under investigation. Riluzole (Rilutek) is the only drug approved by the U.S. Food and Drug Administration (FDA) for ALS, and it has been able to prolong survival in some people. Other treatments under study include a variety of growth factors that might stimulate nerve recovery, lithium, antibiotics and medicines that alter the immune system. So far, however, results have been disappointing. Animal studies have raised hopes about other therapies that might improve nerve and muscle function in people with ALS. These therapies include creatine, vitamin E and celecoxib, but clinical trials have found little or no evidence of effectiveness in humans. The use of stem cells to replace failing cells in the body offers new hope but definitive trials have not yet been reported. Many active clinical trials offer patients the chance to participate in the development of new therapies.

Although there is no cure available for ALS, a number of medications may be helpful for symptoms that may accompany the disease. For example, pain medications and muscle relaxants may help with painful muscle spasticity.

To help manage the symptoms of ALS, mechanical devices, such as dressing aids and special utensils for eating, are available to make self-care easier. A cane or walker also may be helpful for patients who have difficulty walking. Patients should consider the option of using a mechanical respirator if they become unable to breathe on their own. Although artificial ventilation can help some patients survive for years, many patients choose not to be kept alive in a state of total paralysis, unable to communicate except with eye movements. Patients with ALS should discuss this issue with their doctors early in the illness, so that the important and difficult decisions about emergency resuscitation can be made according to the patient's wishes in the event of life-threatening breathing problems.

Emotional support is crucial. Although much of this support can be provided by the patient's friends and family, a qualified counselor or psychotherapist also can be a valuable asset.