A clinical trial of dextromethorphan in amyotrophic lateral sclerosis.
BACKGROUND
Although the cause of amyotrophic lateral sclerosis (ALS) is unknown, excitotoxicity mediated by glutamate has been implicated. Dextromethorphan is a NMDA-glutamate receptor antagonist with neuroprotective properties.


METHODS
The effect of treatment with dextromethorphan (150 mg daily) in ALS patients was evaluated in a randomized, double-blind, placebo-controlled study. Forty-five patients were included in the analysis.


RESULTS
At the end of the treatment period, 12 months after randomization, 15 patients (65%) in the placebo group and 12 patients (55 %) in the dextromethorphan group were still alive (log rank test, P=0.49). Rates of disease progression, as expressed by rates of decline in pulmonary function and in functional disability, were similar in both groups except for a significantly less pronounced rate of decline in the ability scores for the lower extremities in the dextromethorphan group.


CONCLUSIONS
Treatment with a relatively low dose of dextromethorphan did not result in an improvement in 12-month survival in ALS.
Gredal
O
O
Research Institute of Biological Psychiatry, St Hans Hospital, Roskilde, Denmark.
Werdelin
L
L
Bak
S
S
Christensen
P B
PB
Boysen
G
G
Kristensen
M O
MO
Jespersen
J H
JH
Regeur
L
L
Hinge
H H
HH
Jensen
T S
TS
D000328:Adult; D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000188:drug therapy*; D003915:Dextromethorphan / Q000627:therapeutic use*; D004311:Double-Blind Method; D018691:Excitatory Amino Acid Antagonists / Q000627:therapeutic use*; D006801:Humans; D008875:Middle Aged; D010919:Placebos; D016896:Treatment Outcome
D018691:Excitatory Amino Acid Antagonists; D010919:Placebos; D003915:Dextromethorphan