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A clinical trial of dextromethorphan in amyotrophic lateral sclerosis

O Gredal1, L Werdelin, S Bak

  • 1Research Institute of Biological Psychiatry, St Hans Hospital, Roskilde, Denmark.

Abstract

Insights

Dextromethorphan did not improve survival in amyotrophic lateral sclerosis (ALS) patients over 12 months. While it showed a trend toward slower decline in lower extremity function, overall survival and disease progression were similar between groups.

Area of Science:

  • Neuroscience
  • Neurology
  • Clinical Trials

Background:

  • Amyotrophic lateral sclerosis (ALS) pathogenesis involves excitotoxicity mediated by glutamate.
  • Dextromethorphan, an NMDA-glutamate receptor antagonist, exhibits neuroprotective potential.

Purpose of the Study:

  • To evaluate the efficacy of dextromethorphan in treating ALS patients.
  • To assess the impact of dextromethorphan on survival and disease progression in ALS.

Main Methods:

  • A randomized, double-blind, placebo-controlled study was conducted.
  • Forty-five ALS patients received either dextromethorphan (150 mg daily) or a placebo for 12 months.

Main Results:

  • No significant difference in 12-month survival was observed between the dextromethorphan and placebo groups (P=0.49).
  • Disease progression rates, including pulmonary function and functional disability, were comparable between groups.
  • A trend towards a less pronounced decline in lower extremity function scores was noted in the dextromethorphan group.

Conclusions:

  • Low-dose dextromethorphan treatment did not improve 12-month survival in ALS patients.
  • Further research may be needed to explore dextromethorphan's potential effects on specific ALS symptoms or at different dosages.

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