A clinical trial of verapamil in amyotrophic lateral sclerosis.

Seventy-two patients with amyotrophic lateral sclerosis (ALS) were enrolled in a clinical trial of the efficacy of verapamil in the treatment of ALS. In period 1 (pretreatment, months 1-3) and period 3 (posttreatment, months 10-12), patients received no drug. In period 2 (months 4-9), patients received verapamil. The slopes of declining pulmonary function and limb megascores were not significantly different during drug treatment compared to natural history and washout periods. Thus, verapamil was ineffective in slowing the clinical progression in ALS patients. Controlled trials using a natural history period may represent a faster and less expensive method of screening drugs for ALS compared to placebo-controlled trials.