You're Just Too Good to Be True: Lithium Doesn't Work for Amyotrophic Lateral Sclerosis

In a recent Italian study, lithium decreased the morbidity and mortality of amyotrophic lateral sclerosis (ALS) to a remarkable extent. Although this was an unblinded pilot study, the results were impressive, confirming suggestions in several studies that lithium showed efficacy in animal models of ALS. Now, a research consortium from the U.S. and Canada reports results from a larger, multisite, randomized, double-blind, placebo-controlled trial.

Patients had ALS for less than 3 years, were taking riluzole, and had a slow vital capacity of more than 60%. Lithium was titrated to achieve concentrations of 0.4 to 0.8 mEq/L. The primary outcome was time to an event (death or ≥6-point decline on the ALS Functional Rating Scale–Revised). If the co…