Key Information
Clenbuterol’s effects on neuroinflammation, muscle hypertrophy, and mitochondrial activity appear potentially relevant to ALS disease pathology. Data in murine models of motor neurondisease as well as two small flawed clinical trials in PALS are also somewhat promising but due to the small sample sizes, lack of randomization or blind-ing or placebo controls, these must be viewed with caution. In these trials, lower doses (60 lg daily)were better tolerated than higher doses (80 lg twice daily). Clenbuterol has potentially serious adverse cardiac effects at higher doses, and it is not currently approved by the FDA for use in humans in the US. Most of us believe clenbuterol deserves further investigation in ALS, but it cannot currently be endorsed as an effective or safe ALS treatment. There are other beta agonists that maybe safer and more feasible easier to study (1); we are aware of one (salbutamol) is going into the Experts ALS Trial (53) in 2026 (personal communication between RB and CM) and another(CuraCM) (54) that is being developed for multiple indications.