Benjamin Helmold, Carmel Armon, Michael Benatar, Tulio Bertorini, Mark Bromberg, Andrew Brown, Javier Mascias Cadavid, Olimpia Carbunar, Gregory T Carter, Jesse Crayle, Eva Feldman, Juliette Foucher, Jonathan Glass, Ethan Greenstein, Sartaj Jhooty, Nan Jiang, Noah Nathan Kochen, Christopher McDermott, Natasha Olby, Gary Pattee, Devon Porter, Alan Premasari, Anusha Rao, Dylan Ratner, Kim Staats, Elia Tito, Fernando Vieira, Paul Wicks, Richard Bedlack
ALSUntangled reviews alternative and off-label treatments for people living with amyotrophic lateral sclerosis (PALS). In this review, we explore the possibility of using ivermectin to slow ALS progression. Ivermectin's ability to modulate neuroinflammation and excitotoxicity give it plausible mechanisms for treating ALS, though it does not get into the brain very well. One preclinical study demonstrated that ivermectin lengthened lifespan within a mouse model of mSOD1 genetic ALS. This finding has not been replicated. The 2 PALS we found who had data comparing ALSFRS-R progression on and off ivermectin appeared to have no benefit from it. We found no trials of ivermectin in PALS. Ivermectin is low cost and generally well tolerated with most adverse effects being mild and transient, but serious side effects can rarely occur, and it has not been carefully studied in PALS. We cannot at present endorse ivermectin as an ALS treatment.