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The FDA has approved Nuedexta (Avanir), a fixed-dose combination of the cough suppressant dextromethorphan hydrobromide and the antiarrhythmic quinidine sulfate, for oral treatment of pseudobulbar affect. The combination is the first treatment approved by the FDA for this indication. Studies to support the effectiveness of Nuedexta were performed in patients with underlying amyotrophic lateral sclerosis (ALS) or multiple sclerosis (MS); the drug has not been shown to be safe or effective in other types of emotional lability.
PSEUDOBULBAR AFFECT — Pseudobulbar affect, also known as pathological laughter and crying or emotional lability, is common in ALS and MS; it is characterized by involuntary, unexpected outbursts of inappropriate laughing or crying. It can also occur in various other neurological conditions, including traumatic brain injury, stroke and Alzheimer’s disease. Standard treatment has... more
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