PHARMACOTHERAPEUTIC OPTIONS IN THE TREATMENT OF AMYOTROPHIC-LATERAL-SCLEROSIS

Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's diseas e, is a fatally progressive neuromuscular disease. No curative therapy exists; medical therapy is based on symptomatic relief Most investiga tional trials of pharmacologic agents focus on the ALS pathogenesis th eory of excitotoxicity related to the accumulation of glutamate. Riluz ole, the only FDA-approved agent for ALS, inhibits glutamate release p resynaptically. In clinical trials, it has prolonged survival time in patients with early disease. Neurotrophic growth agents are theorized to inhibit motor neuron apoptosis, and one, insulin-like growth factor , has shown modest efficacy in clinical trials. The antiepileptic agen ts gabapentin and lamotrigine appear to inhibit glutamate accumulation , but clinical trials have not shown significant improvements in patie nts.