A clinical trial of dextromethorphan in amyotrophic lateral sclerosis

• Published in: Acta neurologica Scandinavica Vol. 96; no. 1; pp. 8 - 13
• Main Authors: Gredal, O., Werdelin, L., Bak, S., Christensen, P. B., Boysen, G., Kristensen, M. Ø., Jespersen, J. H., Regeur, L., Hinge, H. H., Jensen, T. S.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.07.1997; Blackwell
• Subjects: Adult; Aged; amyotrophic lateral sclerosis; Amyotrophic Lateral Sclerosis - drug therapy; Biological and medical sciences; clinical trial; dextromethorphan; Dextromethorphan - therapeutic use; disease progression; Double-Blind Method; Excitatory Amino Acid Antagonists - therapeutic use; glutamate antagonist; Humans; Medical sciences; Middle Aged; Neuropharmacology; Neuroprotective agent; Pharmacology. Drug treatments; placebo; Placebos; survival; Treatment Outcome; Human; Nervous system diseases; Multicenter study; Amyotrophic lateral sclerosis; Dextromethorphan; Neuroprotective agent; Glutamate; Chemotherapy; Randomization; Treatment; Central nervous system disease; Double blind study; Adult; Clinical trial; Degenerative disease; Antagonist; NMDA receptor; Spinal cord disease
• ISSN: 0001-6314; 1600-0404
• DOI: 10.1111/j.1600-0404.1997.tb00231.x

Introduction ‐ 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. Material and 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. Conclusion ‐ Treatment with a relatively low dose of dextromethorphan did not result in an improvement in 12‐month survival in ALS.