Riluzole

Research summary

Human research on riluzole has largely focused on ALS and other neurological or psychiatric disorders, with essentially no controlled trials in healthy subjects for cognitive enhancement, performance, or general wellness. In ALS, randomized controlled trials and real-world population studies consistently show a modest extension of median survival, typically on the order of a few months in pivotal trials and longer in some observational cohorts. Safety data from these studies indicate that the drug is generally tolerable but associated with a significant rate of liver enzyme elevations and other adverse events. Outside ALS, riluzole has been studied in conditions such as spinal cord injury, Alzheimer’s disease, Parkinson’s disease, Huntington’s disease, depression, and anxiety, generally as a neuroprotective or mood-modulating agent. Results have been mixed, with some signals of benefit in specific contexts and several failed phase 3 trials. Importantly, there is no evidence base supporting the use of riluzole in healthy humans for longevity, cognition, or physical performance, and its adverse effect profile and need for liver monitoring make it unsuitable as a routine “supplement” for otherwise healthy people.