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Table 4 Symptomatic treatments for ALS (with permission from Radunović et al. 2007)
| 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 |
