A CONTROLLED ONE-YEAR TRIAL OF DEXTROMETHORPHAN IN AMYOTROPHIC-LATERAL-SCLEROSIS

In a one-year parallel group double-blind placebo-controlled study of dextromethorphan (1.5 mg/kg) in amyotrophic lateral sclerosis, no sign ificant differences were observed in the rate of progression (Norris s cale) in comparing 24 patients randomly assigned to the dextromethorph an group and 25 patients randomly assigned to the placebo group. Of th e 24 patients in the dextromethorphan group, 17 had limb onset and 7 h ad bulbar onset disease; average duration of disease was 12.5 +/- 6 mo nths and sex ratio (M:F) was 1.4:1. Of the 25 patients in the placebo group, 18 had limb onset and 7 had bulbar onset disease; average durat ion of disease was 9.9 +/- 6 months and sex ratio (M:F) was 1.55:1. De xtromethorphan is a weak noncompetitive N-methyl-D-aspartate (NMDA) an tagonist and higher doses or other potent NMDA receptor antagonists sh ould be tested.