Updated on October 11, 2024
Amyotrophic lateral sclerosis (ALS) is a rare neurological disease that attacks nerve cells in the brain and spinal cord.
These nerve cells (called motor neurons) send signals that control voluntary muscle movement, like walking and talking. When these neurons are damaged, the signals are disrupted, and the ability to control muscle movement is lost.
While every case of ALS is different, symptoms typically include twitching or cramping in muscles, trouble swallowing, muscle weakness, uncontrollable crying or laughing, speech problems, impaired thinking, and difficulty walking, lifting, and climbing stairs. In the advanced stages of the disease, it can become difficult or impossible to breathe. The life expectancy after diagnosis is usually between three and five years.
While the disease can occur at any age, symptoms most often begin between the ages of 55 and 75 years. ALS affects both sexes, though it is slightly more common in people assigned male at birth, and among people who are age 65 years and younger. The cause of ALS is unknown.
Because it’s not a disease that must be reported by law to the Centers for Disease Control and Prevention (CDC), it’s not easy to get an accurate number of how many are living with ALS in the United States in a given year. However, the number is generally estimated by researchers and the CDC to fall somewhere between about 18,000 and 32,000 people.
There is no cure for ALS, but there are medications that a healthcare provider may prescribe for it. These may include medications to help people with ALS maintain daily functioning and live longer. They may also include medications to help address specific symptoms caused by ALS.
Medications that treat ALS
There are several Food and Drug Administration (FDA)-approved medications used to treat ALS. These medications may help slow the progression of the disease and prolong a person’s life.
Some ALS medications work by reducing the level of glutamate in the body. Glutamate is an amino acid (a protein) that helps nerve cells send signals. High levels of glutamate can damage motor neurons. Reducing the levels of glutamate may slow the progression of ALS.
Other medications work by catching unstable molecules, known as reactive oxygen species, and stopping them from damaging cells. It is thought that the presence of too many of these molecules can contribute to the death of motor neurons.
Another ALS medication is designed to only treat those with a particular genetic variant of ALS, known as SOD1-ALS, which stands for superoxide dismutase 1-ALS.
According to the ALS Association, there are more than 50 potential treatments currently being studied, including ones in clinical trials. These may lead to more medication options in the future.
Medications that address symptoms
In addition to medications that treat ALS directly, a healthcare provider may prescribe a number of medications that can ease or help control symptoms that are caused by ALS. These may include medications to help with muscle cramps and spasms, pain, problems with sleep, fatigue, and trouble regulating emotions. If you or a loved one is taking multiple medications, it’s important to understand what each medication does and how and when it should be taken.
In addition to medications, your healthcare provider may recommend working with specialists and therapists, such as physical, occupational, respiratory, speech, and nutrition therapists, along with mental health professionals.
ALS is a different experience for everyone, and it may take time to find the right combination of medications and other therapies that help. If you have any questions or concerns about your diagnosis or treatment, remember that your best source of information will be your healthcare provider.