Which medication is indicated for managing amyotrophic lateral sclerosis (ALS)?

Riluzole is the medication indicated for managing amyotrophic lateral sclerosis (ALS). It is significant because it is the first drug approved specifically for ALS and has been shown to slow the progression of the disease in some patients. Riluzole works by decreasing the release of glutamate, which is believed to contribute to the neurodegeneration seen in ALS. By reducing glutamate levels, the medication helps protect motor neurons from damage, thereby prolonging survival and the time to tracheostomy.

Other medications in the options listed have different uses: pramipexole is typically used for Parkinson’s disease and restless leg syndrome, galantamine is primarily used for Alzheimer's disease as a cholinesterase inhibitor, and glatiramer is used for multiple sclerosis. Each of these agents targets different conditions and mechanisms, which is why they are not suitable for treating ALS. Riluzole remains a cornerstone pharmacologic treatment for ALS, making it the correct choice in this context.