Treatments and drugs

By Mayo Clinic Staff

Because there's no reversing the course of amyotrophic lateral sclerosis, treatments focus on slowing the progression of symptoms, preventing unnecessary complications and making you more comfortable and independent.

Because ALS involves complex physical, mental and social issues, you may find it helpful to have an integrated team of doctors trained in many areas and other health care professionals provide your care. Having an integrated team of doctors and other health care professionals manage your ALS care may prolong your survival and improve your quality of life.

Your team will help you select the right treatments for you. You always retain the right to choose or not choose any of the treatments suggested.

Medications

The drug riluzole (Rilutek) is the only medication approved by the Food and Drug Administration for ALS. The drug appears to slow the disease's progression in some people, perhaps by reducing levels of a chemical messenger in the brain (glutamate) that's often present in higher levels in people with ALS.

Riluzole may cause side effects such as dizziness, gastrointestinal conditions and liver function changes.

Your doctor may also prescribe medications to provide relief from other symptoms, including:

  • Muscle cramps and spasms
  • Spasticity
  • Constipation
  • Fatigue
  • Excessive salivation
  • Excessive phlegm
  • Pain
  • Depression
  • Sleep problems
  • Uncontrolled outbursts of laughing or crying

Therapy

  • Breathing care. Over time, you'll have more difficulty breathing as your muscles become weaker. Doctors may test your breathing regularly and provide you with devices to assist your breathing at night.

    In some cases, you may choose to breathe through mechanical ventilation. Doctors insert a tube in a surgically created hole at the front of your neck leading to your windpipe (tracheostomy), and the tube is connected to a respirator.

  • Physical therapy. A physical therapist can address pain, walking, mobility, bracing and equipment needs that help maintain your independence. Some measures include low-impact exercises to maintain your cardiovascular fitness, muscle strength and range of motion for as long as possible.

    A physical therapist can also help you become accustomed to a brace, walker or wheelchair and may be able to suggest devices such as ramps that make it easier for you to get around.

    Regular exercise can also help improve your sense of well-being. Appropriate stretching can help prevent pain and help your muscles function at their best.

  • Occupational therapy. An occupational therapist can help you compensate for hand and arm weakness in a manner that helps you to keep your independence for as long as possible. Adaptive equipment can help you to continue to perform daily activities such as dressing, grooming, eating and bathing.

    An occupational therapist can also help you understand how to modify your home to allow accessibility if you become less able to walk safely.

    Occupational therapists also have a good understanding of how assistive technology and computers can be used, even if your hands are weak.

  • Speech therapy. Because ALS affects the muscles you use to speak, communication becomes an issue as the disease progresses. A speech therapist can teach you adaptive techniques to make your speech more clearly understood. Speech therapists can also help you explore other methods of communication, such as an alphabet board or simple pen and paper.

    Later in disease progression, a speech therapist can recommend devices such as tablet computers with text-to-speech applications or computer-based equipment with synthesized speech that may help you communicate. Ask your therapist about the possibility of borrowing or renting these devices.

  • Nutritional support. Your team will work with you and your family members to ensure you're eating foods that are easier to swallow and meet your nutritional needs. You may eventually need a feeding tube.
  • Psychological and social support. Your team may include a social worker to help with financial issues, insurance, and getting equipment and paying for devices you may need. Psychologists, social workers and others may provide emotional support for you and your family.
Apr. 09, 2014