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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