ALS: Medications and Treatments

ALS Center for Excellence Patient and Doc Photo

Medication and treatment for ALS focus on slowing symptom progression and providing comfort.

ALS patients have access to a multidisciplinary team – which consists of providers trained in many different areas to help with the complex physical, mental and social issues facing ALS patients. This multidisciplinary integrated team works together to prolong your survival concentrating on your quality of life.

Based on your diagnosis, your team will help you select the right treatments, medications and therapies.

Medications

Rilutek is the only FDA-approved medication to treat ALS. The drug appears to modestly slow disease progression by reducing levels of a chemical messenger in the spinal cord. Side effects of Rilutek may consist of dizziness, nausea and elevated levels of liver enzymes.

Besides Rilutek, there are other medications to relive other individual symptoms. Symptoms able to be treated include:

    ALS Center for Excellence Patient with Pharmacist Photo
  • Pain
  • Depression and fatigue
  • Difficulty with sleep
  • Excessive phlegm or salivation problems
  • Muscle cramps and spasms
  • Muscle stiffness (spasticity)
  • Constipation
  • Uncontrolled outbursts of crying or laughing

     

Therapy

Therapy can include:

Physical therapy. Physical Therapy can address your walking, mobility and equipment needs that help maintain your independence. They can help perform activities that use major muscle groups, such as walking, rising from a chair and getting in and out of bed. Physical therapy may include low-impact exercises to maintain your cardiovascular fitness, muscle strength and range of motion for as long as possible. Exercise can help relax, improve sense of well-being, and prevent pain as well as being a psychological boost.

A physical therapist may provide you with equipment such as a brace, walker or wheelchair  to make it easier for you to get around. A physical therapist can also help you understand how to modify your home to be more accessible if you become less able to walk safely.

ALS Center for Excellence Patient in Wheelchair with Caretaker Photo

Occupational therapy. An occupational therapist can help accomplish daily activities such as eating, dressing, grooming, writing and bathing.

Occupational therapists also have a good understanding of how simple adaptive equipment (such as zipper pulls and handwriting aids) and more complex assistive technology (computers,) can be used, even if your hands are weak.

Speech pathology. Speech-Language Pathologists are an integral part of the multidisciplinary team because as ALS affects the muscles you use to speak, communication becomes an issue as the disease progresses. This is often very frustrating for patients. One of the goals in speech pathology is to maintain a patient’s ability to communicate successfully beyond a loss of the ability to speak.

As the disease progresses, a speech pathologist can recommend devices such as tablet computers with text-to-speech applications or computer-based equipment with synthesized speech and message banking. The Speech-Language Pathologist (SLP) will also evaluate swallowing ability. Assessment of swallowing may take the form of a clinical exam as well as an instrumental study: A modified barium swallow (MBS) test, administered by an SLP and a radiologist, can help provide recommendations to help with swallowing.

Cognitive-linguistic screening is included in the overall assessment to identify changes in behavior, comprehension and higher levels of reasoning and problem solving.

Nutritional support. Your team will work with you and your family members to make sure you're eating nutritious foods that are easier to swallow and that you are meeting your nutritional needs, even when eating becomes more difficult.

Psychological and social support.Psychologists, social workers and others on your team may provide important emotional support for you and your family assisting in insurance matters, equipment acquisition, resource research or financial needs.

Respiratory Management. Over time, you'll have more difficulty breathing as your muscles become weaker. Your doctor may test your breathing regularly and provide you with devices to assist your breathing at night. In some cases, you may choose to breathe through a machine.