ALS untangled #83: clenbuterol
ALS Untangled reviews alternative and off-label treatments for people living with amyotrophic lateral sclerosis (PALS). Here we review clenbuterol, a β-2 adrenergic agonist, as a potential treatment for amyotrophic lateral sclerosis (ALS). Clenbuterol has biological effects that could be relevant to the pathophysiology of ALS such as inducing muscle hypertrophy, improving mitochondrial function, and reducing neuroinflammation. Two studies in mouse models of motor neuron disease and two open label trials suggest possible benefits. However these have methodological flaws which limit interpretation. Clenbuterol can have an array of side effects, some severe. Drop-outs due to side effects were very common in one of the ALS trials and in a separate expanded access program. Based on this information, we cannot currently endorse clenbuterol as an ALS treatment, but we do hope to see further studies of it, or another long acting β-2 adrenergic agonist in people with ALS.
Authors
- E. Pioro
- Fernando G. Vieira (ORCID: https://orcid.org/0000-0003-2996-6418)
- Keelie Denson
- J. David Glass (ORCID: https://orcid.org/0009-0003-1575-2192)
- Benjamin Barnes (ORCID: https://orcid.org/0000-0001-8336-8756)
- W Paul
- Kara A. Dyckman
- Adam Burgess (ORCID: https://orcid.org/0000-0001-9818-2620)
- R. Bowser
- Juliette Foucher (ORCID: https://orcid.org/0000-0001-9026-0268)
- Dario Gelevski (ORCID: https://orcid.org/0000-0002-8287-5331)
- Lyle W. Ostrow
- Benjamin Helmold (ORCID: https://orcid.org/0009-0009-2567-8591)
- Paul E. Barkhaus (ORCID: https://orcid.org/0000-0001-8268-8643)
- Ariah Leday
- Richard Bedlack (ORCID: https://orcid.org/0000-0003-4666-7495)
- Eva Feldman
- E. Mallon
- Jackson Ce
- Elia Tito
- Gary L. Pattee
- Merit Cudkowicz
- Natasha J Olby
- Dylan Ratner
- Basil Elsharif
- Olivia Allen
- Gregory T Carter
- Tulio Bertorini
- Hemangi Sang
- Michael Benatar
- Timothy Fullum
- Sartaj Jhooty
- Christopher Mcdermott
Institutions
- University of North Carolina at Chapel Hill (US)
- Tulane University (US)
- Brooke Army Medical Center (US)
- Allen Institute for Brain Science (US)
- Campbell University (US)
- Barrow Neurological Institute (US)
- Karolinska University Hospital (SE)
- North Carolina State University (US)
- University of Miami (US)
- Emory University (US)
- Eastern Virginia Medical School (US)
- University of Tennessee Health Science Center (US)
- The University of Texas at San Antonio Health Science Center (US)
- Hess (United States) (US)
- Duke University (US)
- Mie University (JP)
- Neurosciences Institute (US)
- Medical College of Wisconsin (US)
- Augusta University (US)
- Wilford Hall Ambulatory Surgical Center (US)
- Amyotrophic Lateral Sclerosis Therapy Development Institute (US)
- Temple College (US)
- University Medical Center (US)
- Neurogen Brain & Spine Institute (IN)
- Hospital La Paz Institute for Health Research (ES)
- Tula University (RU)
- Methodist Hospital (US)
- Duke Medical Center (US)
- Division of Undergraduate Education (US)
- University of Sheffield (GB)
- The University of Texas Health Science Center at Houston (US)
- Georgia Highlands College (US)
Publication Details
- Journal
- Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration
- Published
- 2026-03-08
- DOI
- https://doi.org/10.1080/21678421.2026.2638588
- Primary Topic
- Amyotrophic Lateral Sclerosis Research
- Type
- article
- Field-Weighted Citation Impact
- 0.00