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Anti-Glutamate Therapy in Amyotrophic Lateral Sclerosis: A Trial Using Lamotrigine

Published online by Cambridge University Press:  18 September 2015

Eisen Andrew*
Affiliation:
Neuromuscular Diseases Unit, The Vancouver General Hospital and The University of British Columbia, Vancouver
Stewart Heather*
Affiliation:
Neuromuscular Diseases Unit, The Vancouver General Hospital and The University of British Columbia, Vancouver
Schulzer Michael*
Affiliation:
Neuromuscular Diseases Unit, The Vancouver General Hospital and The University of British Columbia, Vancouver
Cameron Donald*
Affiliation:
Neuromuscular Diseases Unit, The Vancouver General Hospital and The University of British Columbia, Vancouver
*
The Neuromuscular Diseases Unit, The Vancouver General Hospital, 855 West 12th Avenue, Vancouver, British Columbia, Canada V5Z IM9
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Abstract:

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Glutamate excitotoxicity is implicated in the pathogenesis of amyotrophic lateral sclerosis (ALS). We report the results of a double blind, placebo controlled, trial using 100 mg of oral daily lamotrigine (3,5-diamino-6-(2,3 dichlorophenyl)-l,2,4-triazine) which inhibits glutamate release. 67 patients were entered and at trial termination of 1.5 years 15 had withdrawn (9 active and 6 placebo) and 12 had died (6 active and 6 placebo). Mean age at entry was 57.5 years for the active and 58.6 years for the placebo groups. Patients were seen at 3 monthly intervals and scored according to neurological deficit based upon age of onset, bulbar and respiratory involvement, ambulation and functional disability. The mean change in clinical scores for the active versus placebo groups over the trial period was 7.1 ± 3.3 and 9.0 ± 3.3 respectively (0.05 < p < 0.10). Changes in cortical threshold and MEP/CMAP ratios to magnetic stimulation also did not differ significantly between the two groups. We conclude that lamotrigine in the doses administered does not alter the course of ALS.

Type
Research Article
Copyright
Copyright © Canadian Neurological Sciences Federation 1993

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