Dextromethorphan/quinidine: in pseudobulbar affect
- PMID:21476614
- DOI: 10.2165/11207260-000000000-00000
Dextromethorphan/quinidine: in pseudobulbar affect
Abstract
Pseudobulbar affect is characterized by uncontrollable, inappropriate laughing and/or crying that is either unrelated or out of proportion to the emotions felt by the patient and occurs in patients with neurological disorders, such as amyotrophic lateral sclerosis (ALS), multiple sclerosis or traumatic brain injury. Dextromethorphan/quinidine is indicated in the US for the treatment of pseudobulbar affect. Dextromethorphan, when its metabolism is inhibited by the coadministration of quinidine, has been shown to have a positive effect on the symptoms of pseudobulbar affect. Dextromethorphan/quinidine 20 mg/10 mg twice daily was associated with a significantly greater decrease in the rate of pseudobulbar affect episodes per day (primary endpoint) than placebo in the 12-week, randomized, double-blind, placebo-controlled, multicentre STAR trial (Safety, Tolerability, And efficacy Results trial of AVP-923 in PBA [pseudobulbar affect]) involving patients with pseudobulbar affect and ALS or multiple sclerosis. Moreover, the mean change from baseline in Center for Neurologic Study-Lability Scale score at 12 weeks was significantly greater among recipients of dextromethorphan/quinidine 20 mg/10 mg twice daily than those receiving placebo. Dextromethorphan/quinidine 20 mg/10 mg twice daily was generally well tolerated. The drug has been shown to cause dosage-dependent corrected QT interval (QTc) prolongation; however, in the STAR trial, dextromethorphan/quinidine 20 mg/10 mg twice daily appeared to be well tolerated with regard to QTc prolongation.
Similar articles
- Randomized, controlled trial of dextromethorphan/quinidine for pseudobulbar affect in multiple sclerosis.Panitch HS, Thisted RA, Smith RA, Wynn DR, Wymer JP, Achiron A, Vollmer TL, Mandler RN, Dietrich DW, Fletcher M, Pope LE, Berg JE, Miller A; Psuedobulbar Affect in Multiple Sclerosis Study Group.Panitch HS, et al.Ann Neurol. 2006 May;59(5):780-7. doi: 10.1002/ana.20828.Ann Neurol. 2006.PMID:16634036Clinical Trial.
- Dextromethorphan/quinidine for the treatment of pseudobulbar affect.Patatanian E, Casselman J.Patatanian E, et al.Consult Pharm. 2014 Apr;29(4):264-9. doi: 10.4140/TCP.n.2014.264.Consult Pharm. 2014.PMID:24704895Review.
- 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.Pattee GL, Wymer JP, Lomen-Hoerth C, Appel SH, Formella AE, Pope LE.Pattee GL, et al.Curr Med Res Opin. 2014 Nov;30(11):2255-65. doi: 10.1185/03007995.2014.940040. Epub 2014 Jul 28.Curr Med Res Opin. 2014.PMID:25062507Free PMC article.Clinical Trial.
- Dextromethorphan/quinidine: a review of its use in adults with pseudobulbar affect.Yang LP, Deeks ED.Yang LP, et al.Drugs. 2015 Jan;75(1):83-90. doi: 10.1007/s40265-014-0328-z.Drugs. 2015.PMID:25420446Review.
- AVP-923, a combination of dextromethorphan hydrobromide and quinidine sulfate for the treatment of pseudobulbar affect and neuropathic pain.Olney N, Rosen H.Olney N, et al.IDrugs. 2010 Apr;13(4):254-65.IDrugs. 2010.PMID:20373255Review.
Cited by
- Targeting Sigma Receptors for the Treatment of Neurodegenerative and Neurodevelopmental Disorders.Malar DS, Thitilertdecha P, Ruckvongacheep KS, Brimson S, Tencomnao T, Brimson JM.Malar DS, et al.CNS Drugs. 2023 May;37(5):399-440. doi: 10.1007/s40263-023-01007-6. Epub 2023 May 11.CNS Drugs. 2023.PMID:37166702Free PMC article.Review.
- Amyotrophic lateral sclerosis: update and new developments.Pratt AJ, Getzoff ED, Perry JJ.Pratt AJ, et al.Degener Neurol Neuromuscul Dis. 2012 Feb;2012(2):1-14. doi: 10.2147/DNND.S19803.Degener Neurol Neuromuscul Dis. 2012.PMID:23019386Free PMC article.
- Deuterium in drug discovery: progress, opportunities and challenges.Di Martino RMC, Maxwell BD, Pirali T.Di Martino RMC, et al.Nat Rev Drug Discov. 2023 Jul;22(7):562-584. doi: 10.1038/s41573-023-00703-8. Epub 2023 Jun 5.Nat Rev Drug Discov. 2023.PMID:37277503Free PMC article.Review.
- Enhanced Bulbar Function in Amyotrophic Lateral Sclerosis: The Nuedexta Treatment Trial.Smith R, Pioro E, Myers K, Sirdofsky M, Goslin K, Meekins G, Yu H, Wymer J, Cudkowicz M, Macklin EA, Schoenfeld D, Pattee G.Smith R, et al.Neurotherapeutics. 2017 Jul;14(3):762-772. doi: 10.1007/s13311-016-0508-5.Neurotherapeutics. 2017.PMID:28070747Free PMC article.Clinical Trial.
- The epidemiology and pathophysiology of pseudobulbar affect and its association with neurodegeneration.King RR, Reiss JP.King RR, et al.Degener Neurol Neuromuscul Dis. 2013 May 27;3:23-31. doi: 10.2147/DNND.S34160. eCollection 2013.Degener Neurol Neuromuscul Dis. 2013.PMID:30890891Free PMC article.Review.
References
Publication types
MeSH terms
Substances
Related information
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical
Miscellaneous