Dextromethorphan Plus Ultra Low‐Dose Quinidine Reduces Pseudobulbar Affect

  title={Dextromethorphan Plus Ultra Low‐Dose Quinidine Reduces Pseudobulbar Affect},
  author={Erik P. Pioro and Benjamin Rix Brooks and Jeffrey L. Cummings and R. Schiffer and Ronald A. Thisted and Daniel R Wynn and Adriana Hepner and Randall Kaye},
  journal={Annals of Neurology},
To evaluate dextromethorphan combined with ultra low‐dose quinidine (DMq) for treating pseudobulbar affect (PBA) in patients with amyotrophic lateral sclerosis (ALS) or multiple sclerosis (MS). 

Efficacy of Dextromethorphan plus Quinidine Demonstrated for Pseudobulbar Affect

Pseudobulbar affect (PBA), a severe outburst of emotional expression incongruous to a patient's emotional state, can occur in patients with amyotrophic

Dextromethorphan/quinidine for pseudobulbar affect associated with subarachnoid hemorrhage

A 43-year-old woman who developed PBA following an acute subarachnoid hemorrhage with a basilar artery aneurysm is described, who was treated with dextromethorphan/quinidine and showed a reduction in her PBA symptoms.

Pharmacotherapeutic management of pseudobulbar affect.

  • Jack J. Chen
  • Medicine
    The American journal of managed care
  • 2017
This activity will update pharmacists and other healthcare professionals on current treatments for pseudobulbar affect (PBA). Points of discussion will focus on the off-label therapies traditionally

Dextromethorphan/Quinidine: A Review of Its Use in Adults with Pseudobulbar Affect

Although longer-term efficacy and tolerability data for dextromethorphan/quinidine 20/10 or 30/10 mg twice daily would be beneficial, current evidence indicates that it is a useful option in the treatment of adults with PBA.

Dextromethorphan Hydrobromide and Quinidine Sulfate

  • Medicine
  • 2013
The place in therapy of DHQ is not totally elucidated but it may be appropriate to consider it a second line agent except in cases where contraindications to SSRI or TCA exist for specific patients.

Dextromethorphan/quinidine for the treatment of pseudobulbar affect.

  • E. PatatanianJ. Casselman
  • Medicine
    The Consultant pharmacist : the journal of the American Society of Consultant Pharmacists
  • 2014
Based on the data available, DM/Q may be a viable, short-term treatment alternative for PBA, and long-term safety and efficacy data are lacking.

Review of Dextromethorphan 20 mg/Quinidine 10 mg (NUEDEXTA®) for Pseudobulbar Affect

  • E. Pioro
  • Medicine, Psychology
    Neurology and Therapy
  • 2014
Dextromethorphan (DM) hydrobromide combined with quinidine sulfate (Q) as treatment of PBA is described and the ongoing debates concerning the terminology for dysfunction of emotional expression, as well as the ongoing searches for its brain substrates are surveyed.

Mechanism of action of dextromethorphan/quinidine: comparison with ketamine

  • S. Stahl
  • Psychology, Medicine
    CNS Spectrums
  • 2013
Attempts are made to find an agent with ketamine's properties that can be administered orally in repeated doses in order to sustain that action, and here the pharmacologic mechanism of action is compared and contrasted with that of ketamine.



Randomized, controlled trial of dextromethorphan/quinidine for pseudobulbar affect in multiple sclerosis

To evaluate the efficacy and safety of DM/Q (capsules containing dextromethorphan [DM] and quinidine [Q]) compared with placebo, taken twice daily, for the treatment of pseudobulbar affect over a

Dextromethorphan: Enhancing its systemic availability by way of low‐dose quinidine‐mediated inhibition of cytochrome P4502D6

It is estimated that brain dextromethorphan concentrations of 1.0 to 10 µg/gm may be attainable in humans by inhibition of cytochrome P4502D6 activity with quinidine.

Sertraline in stroke‐associated lability of mood

To assess whether a selective serotonin reuptake inhibitor is effective in the treatment of stroke‐associated lability of mood, a large number of animals have been treated with this drug and the results have shown promising results.

Review of pseudobulbar affect including a novel and potential therapy.

  • R. SchifferL. Pope
  • Psychology, Medicine
    The Journal of neuropsychiatry and clinical neurosciences
  • 2005
Evidence suggests that treatment with a fixed combination of dextromethorphan and the cytochrome P450 2D6 enzyme inhibitor, quinidine, can improve PBA.

Pathologic laughing and crying treated with levodopa.

Because part of pathologic laughing and crying seems to be caused by the decreased function of the dopaminergic neuron, levodopa or amantadine is worth trying.

Treatment of pathologic laughing and weeping with amitriptyline.

It is concluded that amitriptyline is effective in the treatment of this disturbance of affective expression, and that this effect is distinct from the antidepressant effect of the medication.

Fluoxetine improves emotional incontinence.

The efficacy of fluoxetine was investigated in 13 patients with emotional incontinence and all 13 patients demonstrated dramatic improvement in emotional lability within 3 to 14 days.

Paroxetine versus citalopram treatment of pathological crying after brain injury.

Rap onset (within 1-3 days) and highly significant (p < 0.001) improvements of emotionalism were observed after both paroxetine and citalopram, and there were no efficacy differences, despite the longer symptom duration in the cITALopram group.