Pyridostigmine
Pyridostigmine has a plausible mechanism for transiently enhancing neuromuscular transmission in early stage ALS, where NMJ transmission is impaired but motor neuron numbers are preserved. However, there is no plausible mechanism for slowing ALS progression. Case reports showed PALS without typical MG symptoms did not respond to pyridostigmine. Thus far, clinical trials of pyridostigmine in […]
WAHLS Protocol
Because components of the Wahls diet may affect inflammation, oxidative stress and mitochondrial dysfunction, it has plausible mechanisms for slow-ing ALS. Although a cross sectional study suggests the intake of certain macro and micronutrients enriched in the Wahls diet was associated with better baseline motor function and lower risk for getting ALS, no case reports […]
PoNS Device
Considering the fact that electrical stimulation was first used as a medical treatment more than 100 years ago (30), and first used as an ALS treatment 30 years ago (31), it is disappointing that we have yet to find a clear way to use this to help PALS. PoNS™ is a newer version of this. […]
Nuedexta
Nuedexta has plausible mechanisms for improving bulbar function in PALS. Some PALS reported concomitant improvement in bulbar function for at least a short period when taking Nuedexta for PBA. A well designed phase II trial in PALS demonstrated the efficacy of Nuedexta in patient-reported bulbar function, and the preliminary result of another trial showed improvement […]
Glucocorticoid Corticosteroids
In conclusion, corticosteroids are a class of medications with wide ranging clinical uses and well studied effects on the immune system. ALS progression is associated with changes in immune system function, with the early disease states associated with anti inflammatory immune markers and the advanced disease states associated withpro inflammatory immune markers. Although treatment with […]
Butyrates
Butyrates have plausible mechanisms for slowing ALS progression and positive pre clinical studies. One trial suggests that sodium phenylbutyrate (NaPB) in combination with Tauroursodeoxycholic acid (TUDCA) can slow ALS progression and prolong survival, but the specific contribution of NaPB toward this effect is unclear. Butyrates appear reasonably safe for use in humans. Based on the […]
RT001
RT001 has a novel mechanism for reducing oxidative stress that could theoretically work better than more traditional antioxidants. In the small trial of patients with Friedreich’s ataxia, it seems to be safe and well-tolerated at lower dosages but can cause nausea and diarrhea at higher doses. At the time of this writing, there is very […]
Antiretrovirals
Antiretrovirals are a group of diverse drugs developed for HIV infections that vary widely in theoretical efficacy against HERVs, side effect profiles, and cost. HERV expression is apparently increased in some PALS; however, it is unknown if this is abeneficial, neutral, or pathological process. Furthermore, it is not clear if ARV-targeted mechanisms such as cell […]