A double-blind randomized clinical trial in amyotrophic lateral sclerosis using lamotrigine: effects on CSF glutamate, aspartate, branched-chain amino acid levels and clinical parameters.
OBJECTIVE
A study was conducted to examine the effect of lamotrigine (LTG) in amyotrophic lateral sclerosis (ALS).


METHODS
Patients were entered in a double-blind, placebo-controlled, crossover study. None of the patients were treated with riluzole, which was not approved for treatment of ALS in Sweden when the study started. After randomization, each patient was treated with placebo or LTG 300 mg daily, followed by a washout period and a second treatment period.


RESULTS
Thirty patients completed the study and were included in the analysis of the primary outcome, which was measured with clinical scales. The cerebrospinal fluid (CSF) levels of glutamate, aspartate, branched-chain amino acids and LTG were also measured. Changes for glutamate, valine and LTG were found during the progression of the disease. The clinical parameters and the levels of CSF amino acids were similar for the two treatment groups.


CONCLUSIONS
No clinical effect of LTG on ALS progression could be found.
Ryberg
H
H
Institute of Clinical Neuroscience at University of Göteborg, Göteborg, Sweden.
Askmark
H
H
Persson
L I
LI
D000328:Adult; D000368:Aged; D000597:Amino Acids, Branched-Chain / Q000134:cerebrospinal fluid* / Q000187:drug effects*; D000690:Amyotrophic Lateral Sclerosis / Q000134:cerebrospinal fluid* / Q000188:drug therapy* / Q000503:physiopathology; D001224:Aspartic Acid / Q000134:cerebrospinal fluid* / Q000187:drug effects*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D018691:Excitatory Amino Acid Antagonists / Q000134:cerebrospinal fluid / Q000494:pharmacology* / Q000627:therapeutic use*; D005260:Female; D018698:Glutamic Acid / Q000134:cerebrospinal fluid* / Q000187:drug effects*; D006801:Humans; D000077213:Lamotrigine; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D014227:Triazines / Q000134:cerebrospinal fluid / Q000494:pharmacology* / Q000627:therapeutic use*
D000597:Amino Acids, Branched-Chain; D018691:Excitatory Amino Acid Antagonists; D014227:Triazines; D001224:Aspartic Acid; D018698:Glutamic Acid; D000077213:Lamotrigine