Emerging treatments
Clonidine
Inhibits acetylcholine release and acts as a central nervous system sedative. One small trial indicated that low-to-moderate doses are tolerated, but much larger trials are required to determine if it is clinically effective.[27]
Magnesium
Inhibits acetylcholine release and acts as an anticonvulsant. Small, poor-quality trials have reported lower mortality; however, larger studies are under way.[28][29]
Sodium bicarbonate
Unknown mechanism of action; however, small poor-quality trials have reported lower mortality.[30] Better evidence is required before this treatment is recommended.[28]
Lipid emulsions
One meta-analysis of Chinese language randomised controlled trials reported benefit with lipid emulsion therapy.[31] Most of the included trials were small, and quality was difficult to evaluate. There are several theoretical concerns with recommending this treatment. The mechanism is unclear, and it may also interfere with other treatments.[28]
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