A report on mice demonstrated that the deficit in glutamate uptake becomes more severe by end point of the condition and is probably the cause for the loss of efficiency of the drug in advanced ALS. 12 More studies are for that reason required, particularly to date=june 2011 the results of riluzole in older patients, in supplier Everolimus bulbar ALS, and in patients with more high level illness. Memantine Memantine is a low affinity, non-competitive antagonist of both open channel N methyl D aspartate and calcium permeable amino 3 hydroxy 5 methyl 4 isoxazole propionic acid glutamate receptors. It enables the restriction of extortionate NMDA receptors action, without disrupting normal synaptic transmission. Various in vitro and in vivo models of excitotoxicity showed that memantine has neuroprotective properties14 and the drug has been used clinically with excellent protection in various neurodegenerative disorders, including Alzheimer s infection. Two recent animal studies on SOD1 transgenic mice unearthed that the drug works well in increasing success and delaying progression of transgenic mice. In one study, the management of memantine had therapeutic effects, even when given at symptoms on-set. Data on ALS patients are missing, even though one phase II clinical trial in Urogenital pelvic malignancy US and combined phase II CIII clinical studies are ongoing L Arginine is a semi-essential amino acid that acts as sole substrate for enzymes associated with diverse cell functions. Pre-clinical studies have discovered that L arginine protects cultured motor neurons from glutamate excitotoxic injury. The mechanism underlying these favorable results remains unknown but could be linked to the formation of neuroprotective polyamines, required for neuronal survival and regeneration. 19 L-arginine supplementation in SOD1 transgenic ALS mice, administrated both prior to and after the angiogenesis in vivo onset of motor neuron damage, dramatically slowed the development of neuropathology in lumbar back, delayed onset of motor dysfunction, and prolonged life time. More over, lower plasma L-arginine levels have been reported in ALS patients, probably as a result of malnutrition connected with advanced ALS. While L-arginine has strong in vitro and in vivo neuroprotective properties and can be a candidate for therapeutic trials in ALS, information on humans lack. Ceftriaxone Ceftriaxone, a beta lactam antibiotic, modulates the expression of glutamate transporter GLT1 via gene activation and might also act as metal chelator. Pre-clinical studies demonstrated that it prolongs survival in different animal types of ALS. This compound is used extensively in people and is safe.