The Medical Letter on Drugs and Therapeutics
Dextromethorphan/Quinidine (Nuedexta) for Pseudobulbar Affect
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Revised 7/7/11: "in patients with ALS or MS" was deleted at the end of the first sentence and a new sentence was added to the end of the paragraph. Also, in the Drug Interactions paragraph, the second sentence has been revised.

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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Title: Dextromethorphan Quinidine (Nuedexta) for Pseudobulbar Affect
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