Early experience confirms that riluzole improves survival and is well tolerated
The recently established Australian Motor Neurone Disease Registry estimates that 1200 Australians are living with motor neurone disease (MND), and 370 new patients are diagnosed each year. Most patients die within 3 years of diagnosis. Aetiological mechanisms implicated in the development of MND have been linked to the glutamatergic neurotransmitter system, with excessive activation of glutamate receptors at the synaptic cleft now believed to trigger destruction of motor neurones.1 This “excitotoxicity” theory of MND gave rise to the development of new therapeutic approaches and, ultimately, clinical trials involving riluzole. This drug was initially thought to act solely as an inhibitor of glutamate release, although subsequent postulated effects include indirect antagonism of glutamate receptors and inactivation of neuronal voltage-gated sodium ion channels.
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Research support from the Motor Neurone Disease Research Institute of Australia is gratefully acknowledged.