Treatment of pseudobulbar affect in ALS with dextromethorphan/quinidine
@article{Brooks2004TreatmentOP, title={Treatment of pseudobulbar affect in ALS with dextromethorphan/quinidine}, author={Benjamin Rix Brooks and Ronald A. Thisted and Stanley H Appel and Walter G Bradley and Richard Olney and James E. Berg and Laura E. Pope and R A Smith}, journal={Neurology}, year={2004}, volume={63}, pages={1364 - 1370} }
Background: Patients with ALS commonly exhibit pseudobulbar affect. Methods: The authors conducted a multicenter, randomized, double-blind, controlled, parallel, three-arm study to test a defined combination of dextromethorphan hydrobromide (DM) and quinidine sulfate (Q) (AVP-923) for the treatment of pseudobulbar affect in ALS. Q inhibits the rapid first-pass metabolism of DM. The effects of AVP-923 (30 mg of DM plus 30 mg of Q) given twice daily for 28 days were compared with those of its…
194 Citations
Dextromethorphan/quinidine for the treatment of pseudobulbar affect.
- MedicineThe 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.
Dextromethorphan/Quinidine
- Medicine, PsychologyReactions Weekly
- 2017
The drug has been shown to cause dosage-dependent corrected QT interval (QTc) prolongation; however, in the STAR trial, dextromethorphan/quinidine 20mg/10mg twice daily appeared to be well tolerated with regard to QTc prolongation.
Dextromethorphan/quinidine for pseudobulbar affect
- Psychology, Medicine
- 2014
Dextromethorphan/quinidine (DM/Q; NUEDEXTA) is approved by the US FDA for the treatment of pseudobulbar affect (PBA) associated with chronic neurological disorders such as multiple sclerosis, stroke,…
Dextromethorphan/quinidine sulfate for pseudobulbar affect.
- MedicineDrugs of today
- 2008
DM/Q was recently shown to be effective in reducing the severity of PBA in two large studies of ALS and multiple sclerosis, which are probably the most common neurological settings, and the agent was safe and relatively well tolerated.
An open-label multicenter study to assess the safety of dextromethorphan/quinidine in patients with pseudobulbar affect associated with a range of underlying neurological conditions
- Medicine, PsychologyCurrent medical research and opinion
- 2014
DM/Q was generally well tolerated over this 52 week trial in patients with PBA associated with a wide range of neurological conditions, and differences in AEs across neurological disease groups appeared consistent with the known morbidity of the primary neurological conditions.
Therapeutic use of dextromethorphan: Key learnings from treatment of pseudobulbar affect
- Psychology, MedicineJournal of the Neurological Sciences
- 2007
Evaluating the safety and efficacy of dextromethorphan/quinidine in the treatment of pseudobulbar affect
- Medicine, PsychologyNeuropsychiatric disease and treatment
- 2014
The use of DM/Q in the treatment of PBA is supported by three published efficacy and safety studies; significant effects were seen on the primary end point, the Center for Neurologic Study-Lability Scale, as well as secondary efficacy end points and quality of life.
Review of Dextromethorphan 20 mg/Quinidine 10 mg (NUEDEXTA®) for Pseudobulbar Affect
- Medicine, PsychologyNeurology 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.
Current Concepts in the Pharmacotherapy of Pseudobulbar Affect
- Medicine, PsychologyDrugs
- 2012
Across all placebo-controlled trials, response to active treatment — either an antidepressant or dextromethorphan/quinidine — has in general been significantly greater than response to placebo, but placebo response has sometimes been substantial, suggesting caution in interpreting uncontrolled findings.
References
SHOWING 1-10 OF 36 REFERENCES
A controlled one-year trial of dextromethorphan in amyotrophic lateral sclerosis.
- Medicine, PsychologyClinical neuropharmacology
- 1996
Dextromethorphan is a weak noncompetitive N-methyl-D-aspartate (NMDA) antagonist and higher doses or other potent NMDA receptor antagonists should be tested.
Treatment of pathologic laughing and weeping with amitriptyline.
- Psychology, MedicineThe New England journal of medicine
- 1985
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.
High‐dose dextromethorphan in amyotrophic lateral sclerosis: Phase I safety and pharmacokinetic studies
- Medicine, BiologyAnnals of neurology
- 1994
This study demonstrates the feasibility of long‐term administration of high‐dose DM in ALS, as well as in other conditions associated with glutamate excitotoxicity.
A pilot trial of dextromethorphan in amyotrophic lateral sclerosis.
- Medicine, PsychologyJournal of neurology, neurosurgery, and psychiatry
- 1993
No positive effects on clinical or neurophysiological parameters (relative number of axons, and compound muscle action potentials in the abductor digiti minimi muscle) were observed either in the double-blind trial or in the open trial.
Pharmacokinetics of Dextromethorphan After Single or Multiple Dosing in Combination With Quinidine in Extensive and Poor Metabolizers
- MedicineJournal of clinical pharmacology
- 2004
Results from both studies indicated that 25 to 30 mg Q is adequate to maximally suppress O‐demethylation of DM, with no difference between extensive and poor metabolizer phenotypes.
Pathological crying and laughing: treatment with sertraline.
- Medicine, PsychologyArchives of physical medicine and rehabilitation
- 1996
Phenotypic Differences in Dextromethorphan Metabolism
- Medicine, BiologyPharmaceutical Research
- 2004
Ratios of conjugated/free dextrorphan and 3-hydroxymorphinan excreted in the urine suggest also a lack of conjUGative capacity in the PM, relative to the EM.
Determination of dextromethorphan metabolizer phenotype in healthy volunteers
- MedicineEuropean Journal of Clinical Pharmacology
- 2004
The present data are in agreement with previous findings that the oxidative metabolic polymorphisms of debrisoquin and DMP co-segregate; the frequency of the PM phenotype of dextromethorphan in Caucasian populations varies between 5 and 10%.
Dextromethorphan: Enhancing its systemic availability by way of low‐dose quinidine‐mediated inhibition of cytochrome P4502D6
- Medicine, BiologyClinical pharmacology and therapeutics
- 1992
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.
Pathological laughing and crying following stroke: validation of a measurement scale and a double-blind treatment study.
- Psychology, MedicineThe American journal of psychiatry
- 1993
The severity of symptoms in pathological emotional display can be reliably quantified with the Pathological Laughter and Crying Scale, and treatment with nortriptyline can effectively ameliorate this emotional disorder.