Lithium carbonate to be tested for motor neurone disease

Nov 3 2008

Victims of motor neurone disease (MND) will find hope from British research which has found that lithium carbonate, a cheap off-patent drug, may offer a treatment for the disease.

The team at King's College London have recently conducted laboratory tests and animal trials with lithium carbonate and they suggest that it may have a protective effect with MND.

The scientists are now about to embark on a major new trial to assess the impact of lithium carbonate as a treatment for MND and say the research is necessary because positive findings from a small-scale Italian study were "too dramatic too ignore".

Motor neurones are found in the brain and spinal cord - there is currently no effective cure or treatment for the disease which can strike any adult at any age - it is more commonly found in men than women and is most likely to strike between the ages of 50 and 70 - it is often rapidly progressive and always fatal, usually within two to five years.

Lithium has been used for decades as a treatment for depression and an Italian trial of 16 people reported promising results.

The scientists are however urging caution as some side-effects of lithium are potentially dangerous including tremors, stiffness, confusion, kidney damage and harm to the thyroid and they advise patients with the disease not to take the drug in advance of their results.

Professor Nigel Leigh, director of the MND Care Centre at King's College London, one of the study leaders, says they are hoping for something like a 20% reduction in death rate at the end of 18 months, which would translate to an extra three to six months of life, or maybe more if treatment continues beyond the end of the trial.

The new trial will be partly funded by the Department of Health and will begin next year and involve 220 patients with the aim of discovering whether safe doses of lithium carbonate really can benefit people with MND and help them live longer.

Critics of the Italian study say it was small and poorly designed, and suggest that its findings should be treated with caution and question whether the trial was large enough to make the claims that it did.

The director of the MND Care and Research Centre at King's College London, Professor Nigel Leigh, says patients are asking him every day whether they should be trying lithium carbonate, but that only a "tiny minority" are taking it, which is a surprise.

Professor Leigh says the only ethical approach is to do a full clinical trial, where people are randomised "blind", so neither they nor the researchers know if they are taking lithium carbonate or a dummy pill.

The 18-month £1 million study of patients who have had MND for between six months and three years will start at 10 centres across the UK and patients will be monitored closely for side-effects with participants taking one tablet a day.

Professor Leigh says that GPs and patients with MND should wait for the results before taking lithium carbonate, as safety is paramount.

The president of the Royal College of GPs, Professor Steven Field, agrees and says while the information is encouraging, it is important to await results of clinical trials because the medicine has serious side-effects which could potentially make some of the symptoms worse.

Because lithium carbonate is cheap, costing just 2.4p per 200 milligram tablet, a positive outcome from the study is likely to result in most MND patients being offered it.