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Table 4 Symptomatic treatments for ALS (with permission from Radunović et al. 2007)

From: Amyotrophic lateral sclerosis

 

Drugs

Other treatments

Cramps

• Carbamazepine

• Physiotherapy

 

• Phenytoin

• Physical exercise

 

• Quinine (removed from US market)

• Massage

  

• Hydrotherapy

Spasticity

• Baclofen

• Physiotherapy

 

• Tizanidine

• Hydrotherapy

 

• Dantrolene

• Cryotherapy

 

• Botulinum toxin type A

 

Excessive watery saliva

• Atropine

• Home suction device

 

• Hyoscine hydrobromide

• Dark grape juice

 

• Hyoscine butylbromide

• Sugar-free citrus lozenges

 

• Hyoscine scopoderm

• Nebulisation

 

• Glycopyrronium

• Steam inhalation

 

• Amitriptyline

• Injections of botulinum toxin into parotid glands

  

• Irradiation of the salivary glands

Persistent saliva and bronchial secretions

• Carbocisteine

• Home suction device

 

• Propranolol

• Assisted cough insufflator-exsufflator

 

• Metoprolol

• Rehydration (jelly or ice)

  

• Pineapple or papaya juice

  

• Reduced intake of diary products, alcohol, and caffeine

Excessive or violent yawning

Baclofen

 

Laryngospasm

Lorazepam

Reassurance

Pain

• Simple analgesics

Comfort (seating, sleeping, day and night care)

 

• Non-steroidal anti-inflammatory drugs

 
 

• Opioids

 

Emotional lability

• Tricyclic antidepressant

 
 

• Selective serotonin-reuptake inhibitors

 
 

• Levodopa

 
 

• Dextrometorphan and quinidine

 

Communication difficulties

 

• Speaking techniques

  

• Low-tech augmentative and alternative communication tools

  

• Voice amplifiers

  

• Light writers

  

• Scanning systems operated by switches

  

• Brain-computer interfaces

Constipation

• Lactulose

• Hydration

 

• Senna

• Increased fibre intake

Depression

• Amitriptyline

• Psychological support, counselling

 

• Citalopram

 

Insomnia

• Amitriptyline

Comfort, analgesia

 

• Zolpidem

 

Anxiety

Lorazepam

Psychological support, counselling

Fatigue

Modafinil

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