20.2.4.2 Treatment

Riluzole prolongs survival in motor neurone disease by about 60 days, and is considered to be disease-modifying. The mechanism of action of riluzole is unclear. Riluzole probably reduces the neurotoxicity of glutamate by inhibiting the release of glutamate, and blocking some of the glutamate receptors. Riluzole is generally well tolerated. One precaution when using riluzole is to motor liver enzymes (e.g. aminotransferases) as, very occasionally, there is toxicity to the liver with riluzole.

GABA is an inhibitory neurotransmitter in the CNS and spinal cord. GABA inhibits the activity of motor neurones. Baclofen, a GABA_B receptor agonist is used for the symptomatic relief of the spasticity associated with motor neurone disease.