One of the worst symptoms of my mum's experience with ALS (and there are many to choose from) is her emotional lability, she is on 50 mg amytriptyline per day.. I believe that is (or close) to the spelling. It helps her. We can now establish the difference between disturbing emotional reflexes that are part of this disease and her true laughter and sadness. It helps us to recognize the difference between a symptom and our beautiful mum. When she cries now.. I can see pain and fear and tears; before I would brush her hair the wrong way and she would "wail" for ages and then I could stub a toe and bash my head and this would then send her into fits of laughter so severe she would cough, choke and wet herself. Although this scenario sounds funny and it is for a little while.. day in and day out it becomes a draining (taking another hour to clean and change her) and upsetting (because she knows it's inappropriate and can't help herself) experience for everyone involved. Talk to your doctor and explain your concerns.. I'm sure there is something they can suggest.