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TriStar Centennial Medical Center
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Lithium for Amyotrophic Lateral Sclerosis

Amyotrophic lateral sclerosis (ALS), also called Lou Gehrig's disease, is a fast moving and fatal disease that attacks the nerve cells. The damage to the nerves gradually stops all voluntary muscle movement. As many as 20,000 Americans have ALS, and about 5,000 people in the US are diagnosed with the disease each year. There is no cure for ALS. Current treatments focus on providing some relief for symptoms and improving quality of life. A drug called riluzole is the first FDA-approved drug for treating ALS symptoms.

A study published in PNAS (National Academy of Sciences), reviewed the benefits of adding the drug lithium to riluzole treatment. The results showed that this combination may have promise in slowing the progression of the disease and extending life for people with ALS.

About the Study

The study was conducted in Italy at the Universities of Pisa and Novara. Researchers studied 44 patients with ALS for less than five years. About 25% of patients had bulbar presentation, a severe and rapidly progressive form of ALS. The patients were split into two groups:

  • 28 patients were given riluzole 50 mg twice daily
  • 16 patients were given riluzole 50 mg twice daily plus lithium carbonate 150 mg twice daily

Medication was given for 15 months. Lithium levels were monitored for safety and the dose was adjusted to 450 mg/day if necessary to reach the appropriate blood levels.

The tragedy of this disease is death within two to five years in general and within 6-18 months with bulbar disease. Most people with ALS will die from respiratory failure because the muscles used to breathe can no longer function. In this study, after 15 months all of the patients who were taking riluzole and lithium were still alive with preservation of their ability to breathe. In the group who took riluzole alone, about 1/3 of the other group had died with deterioration of their ability to breathe.

How Does This Affect You?

This research had promising results, but was a very small study. Further studies will need to be done to confirm the benefits before it can be adopted as a regular treatment. Discuss the option of lithium treatment with your physician.

  • ALS Association

    http://www.alsa.org

  • National Institute of Neurological Disorders and Stroke

    http://www.ninds.nih.gov/disorders/amyotrophiclateralsclerosis

  • Fornai F, Longone P, Cafaro L, et al. Lithium delays progression of amyotrophic lateral sclerosis. PNAS . 2008 Feb;105:2052-2057. Available at: http://www.pnas.org/cgi/content/full/105/6/2052. Accessed May 2, 2008.

  • National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/amyotrophiclateralsclerosis. . Accessed April 2, 2008.

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