Amyotrophic lateral sclerosis (ALS) is a rapidly progressive neurodegenerative 
disorder; riluzole is marginally effective, and as a consequence a large number 
of trials are regularly reported. Lithium raised marked enthusiasm based on the 
report of a pilot study that suggested very positive results. Two previous 
trials were negative, applying a different methodology. The reviewed article 
reports the results of a third trial using a historical control group. In this 
trial, lithium was detrimental to ALS progression. Two more trials testing 
lithium in ALS are in progress. This study is discussed in the context of the 
great competitive effort that was derived from the unsupported hope created by a 
false-positive preliminary study.