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Charles P Taylor, Stephen F Traynelis, Joao Siffert, Laura E Pope, Rae R Matsumoto
Dextromethorphan (DM) has been used for more than 50years as an over-the-counter antitussive. Studies have revealed a complex pharmacology of DM with mechanisms beyond blockade of N-methyl-d-aspartate (NMDA) receptors and inhibition of glutamate excitotoxicity, likely contributing to its pharmacological activity and clinical potential. DM is rapidly metabolized to dextrorphan, which has hampered the exploration of DM therapy separate from its metabolites. Coadministration of DM with a low dose of quinidine inhibits DM metabolism, yields greater bioavailability and enables more specific testing of the therapeutic properties of DM apart from its metabolites...
August 2016: Pharmacology & Therapeutics
Dynela Garcia-Baran, Thomas M Johnson, Joyce Wagner, Joann Shen, Michelle Geers
Pathological laughing and crying, or pseudobulbar affect (PBA), has been described in patients with neurological disorders such as multiple sclerosis, amyotrophic lateral sclerosis, Alzheimer's disease, stroke, and traumatic brain injury (TBI) since the 19th century (Schiffer 2005). The syndrome is characterized by inappropriate episodes of laughing or crying after minor stimuli. It was first coined a disinhibition of cortical control by Kinnier Wilson in 1924. It was observed in brain disease and seen with mild TBI...
March 2016: Medicine (Baltimore)
Marian W Roman
No abstract text is available yet for this article.
2015: Issues in Mental Health Nursing
Erik P Pioro
Pseudobulbar affect (PBA) is a dysfunction of emotional expression characterized by involuntary outbursts of crying or laughing disproportionate or unrelated to mood, occurring in patients with various underlying neurologic disorders. This review describes the clinical data supporting dextromethorphan (DM) hydrobromide combined with quinidine sulfate (Q) as treatment of PBA and briefly surveys the ongoing debates concerning the terminology for dysfunction of emotional expression, as well as the ongoing searches for its brain substrates...
June 2014: Neurology and Therapy
Lily P H Yang, Emma D Deeks
Fixed-dose dextromethorphan/quinidine capsules (Nuedexta(®)) utilize quinidine to inhibit the metabolism of dextromethorphan, enabling high plasma dextromethorphan concentrations to be reached without using a larger dose of the drug. The drug combination is the first treatment to be approved for pseudobulbar affect (PBA), a condition of contextually inappropriate/exaggerated emotional expression that often occurs in adults with neurological damage conditions, such as amyotrophic lateral sclerosis (ALS), multiple sclerosis (MS), stroke, traumatic brain injury, Alzheimer's disease or Parkinson's disease...
January 2015: Drugs
T Olivier, D Nemeth, C Songy
OBJECTIVE: West Nile Virus (WNV) may evolve into West Nile Encephalitis (WNE) in older individuals. Most of these WNE seniors do not survive. The long-term outcome profiles of those who do survive WNE have not been well studied. This poster will serve as a follow-up to a 2014 INS poster presentation poster of a 74 year-old Caucasian male who was recovering from WNE. Medicare reimburses time-limited rehabilitation services, and many of this individual's lower-level functions were rehabilitated via several months of inpatient and outpatient rehabilitation...
September 2014: Archives of Clinical Neuropsychology: the Official Journal of the National Academy of Neuropsychologists
Bridgette Johnson, Scott Nichols
OBJECTIVE: Pseudobulbar affect/emotional incontinence is a potentially disabling condition characterized by expressions of affect or emotions out of context from the normal emotional basis for those expressions. This condition can result in diagnostic confusion and unrelieved suffering when clinicians interpret the emotional expressions at face value. In addition, the nomenclature, etiology, and treatment for this condition remain unclear in the medical literature. METHOD: We report the case of a 60-year-old woman with multiple sclerosis who was referred to an inpatient psychiatry unit with complaints of worsening depression along with hopelessness, characterized by unrelenting crying...
December 2015: Palliative & Supportive Care
Edna Patatanian, Jessica Casselman
OBJECTIVE: To evaluate the role of dextromethorphan/quinidine (DM/Q; Nuedexta™) in the treatment of pseudobulbar affect (PBA). DATA SOURCES: A literature search of MEDLINE/PubMed (January 1966-June 2013) was conducted using search terms pseudobulbar affect, pathological laughing and/or crying, emotional lability, dextromethorphan, and quinidine. STUDY SELECTION AND DATA EXTRACTION: English language clinical trials and case reports evaluating the safety and efficacy of DM/Q in PBA were included for review...
April 2014: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
Martin Paspe Cruz
Dextromethorphan/quinidine (nuedexta) for pseudobulbar affect.
June 2013: P & T: a Peer-reviewed Journal for Formulary Management
Edward C Lauterbach
It was previously hypothesized that dextromethorphan (DM) and dextrorphan (DX) may possess antidepressant properties, including rapid and conventional onsets of action and utility in treatment-refractory depression, based on pharmacodynamic similarities to ketamine. These similarities included sigma-1 (σ(1)) agonist and NMDA antagonist properties, calcium channel blockade, muscarinic binding, serotonin transporter (5HTT) inhibition, and μ receptor potentiation. Here, six specific hypotheses are developed in light of additional mechanisms and evidence...
June 2012: Medical Hypotheses
(no author information available yet)
No abstract text is available yet for this article.
June 13, 2011: Medical Letter on Drugs and Therapeutics
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