ALS Untangled

Supports a claim in this answer

Nuedexta treats pseudobulbar affect and does not slow ALS/MND progression; a 2017 randomised crossover trial tested it for speech and swallowing, which is off-label use

!Qualifies this

“Nuedexta's longer term effect on speech and swallowing is unclear, and one open label study found no benefit at one year.”

Sets this caution alongside its support for trying Nuedexta for bulbar problems: the long term effect on bulbar function is unclear and one open label study found no benefit at one year. It grades the risks C and suggests checking periodically whether it is still helping.

However, its long term effect on bulbar function is unclear, and one open label study showed a lack of benefit in one year.

Key Information

!Qualifies this

“Nuedexta treats pseudobulbar affect. It does not slow the progression of ALS/MND or help people live longer.”

An independent graded review, last checked in June 2026, which puts this slightly differently. It reports an absence of evidence that Nuedexta slows progression, rather than evidence that it does not, which is a weaker claim than the answer makes.

There is no evidence suggesting Nuedexta slows down progression or prolongs survival.

Key Information

✓Supports this

“In a 2017 randomised crossover trial in 60 people, with 28 day periods, people rated their own bulbar function better on Nuedexta. A preliminary result from another trial showed improved bulbar physiology. An independent review supports considering it for bulbar problems and wants more research.”

An independent graded review, last checked June 2026, which reaches the same conclusion from the same trial and grades the trial evidence C. It notes that a preliminary result from another trial showed improvement in bulbar physiology.

A well designed phase II trial in PALS demonstrated the efficacy of Nuedexta in patient-reported bulbar function, and the preliminary result of another trial showed improvement in bulbar physiology.

Key Information

Further reading

Independent review of the evidence and limitations