title: Complementary and Alternative Therapies in Amyotrophic Lateral Sclerosis.
abstract: Given the severity of their illness and lack of effective disease-modifying agents, it is not surprising that most patients with amyotrophic lateral sclerosis (ALS) consider trying complementary and alternative therapies. Some of the most commonly considered alternative therapies include special diets, nutritional supplements, cannabis, acupuncture, chelation, and energy healing. This article reviews these in detail. The authors also describe 3 models by which physicians may frame discussions about alternative therapies: paternalism, autonomy, and shared decision making. Finally, the authors review a program called ALSUntangled, which uses shared decision making to review alternative therapies for ALS.
authors.affiliation: Department of Neurology, Duke University Medical Center, Durham, NC 27702, USA. Electronic address: Bedla001@mc.duke.edu.
authors.forename: Richard S
authors.initials: RS
authors.lastname: Bedlack
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of California, Davis School of Medicine, 4860 Y Street Suite 3850, Sacramento, CA 95817, USA.
authors.forename: Nanette
authors.initials: N
authors.lastname: Joyce
authors.affiliation: Department of Physical Medicine and Rehabilitation, St. Luke's Rehabilitation Institute, 711 South Cowley, Spokane, WA 99202, USA.
authors.forename: Gregory T
authors.initials: GT
authors.lastname: Carter
authors.affiliation: Spaulding Rehabilitation Hospital, Boston VA Health Care System, Harvard Medical School, Massachussets General Hospital, Boston, MA 02114, USA.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Paganoni
authors.affiliation: Department of Neurology, University of North Carolina School of Medicine, 170 Manning Drive, Campus Box 7025, Chapel Hill, NC 27599-7025, USA.
authors.forename: Chafic
authors.initials: C
authors.lastname: Karam
mesh_terms: D000690:Amyotrophic Lateral Sclerosis / Q000628:therapy*; D000529:Complementary Therapies / Q000379:methods*; D003657:Decision Making; D006801:Humans
keywords: Autonomy; Complementary and alternative medicine; Paternalism