Factors influencing a patient's decision regarding riluzole: an early experience

Riluzole is the first drug to be approved in the United States for the treatment of amyotrophic lateral sclerosis (ALS). During the first 8 months of the drug's availability by prescription, its use was discussed with 46 patients with probable or definite ALS as defined by the E1 Escorial criteria. Seventeen of the patients (37%) chose to take riluzole while 29 (63%) refused. Increased duration of symptoms, increased time since diagnosis, and participation in either the insulin-like growth factor-1 (IGF-1) and brain-derived neurotrophic factor (BDNF) trials were all associated with decreased likelihood of starting the drug. The most common reason given for not wanting to take the medication was insufficient benefit.