Dextromethorphan/quinidine for pseudobulbar affect
Current Psychiatry. 2011 February;10(02):60-67
February 1, 2011|Current Psychiatry
Author and Disclosure Information
The combination of dextromethorphan and quinidine reduced the number of daily PBA episodes in 3 randomized trials
Related Resource
- Neudexta [package insert]. Aliso Viejo, CA: Avanir Pharmaceuticals; 2010.
Drug Brand Names
- Amantadine • Symmetrel
- Dextromethorphan/quinidine •Nefazodone
- Ketoconazole • Nizoral
- Levodopa • Sinemet
- Neudexta • Serzone
- Quinidine • Quinidex
Disclosures
Dr. Dubovsky receives research support from Biogen Idec, Bristol-Myers Squibb, Dainippon Sumitomo Pharma, Otsuka, the Peter and Elizabeth C. Tower Foundation, and Pfizer, Inc.
Dr. Tan reports no financial relationship with any company whose products are mentioned in this article or with manufacturers of competing products.
Table 2
Dextromethorphan/quinidine for PBA: Evidence shows efficacy
| Study | Patients | Dosages | Results |
|---|---|---|---|
| Panitch et al, 200610; 85-day, randomized, double-blind, placebo-controlled | 150 MS patients with PBA | DMQ 30-30 or placebo, given twice a day | DMQ 30-30 was associated with greater reductions in CNC-LS scores, fewer PBA episodes, improvement in QOL and QOR, and decrease in pain intensity |
| Pope, 20065; 3-arm, double-blind, 28-day phase III multicenter trial | 140 ALS patients with PBA | DMQ 30-30, DM, 30 mg, or quinidine, 30 mg, given twice daily | DMQ 30-30 was associated with greater decreases in CNC-LS scores and number of laughing and crying episodes and improvements in QOL and QOR compared with DM or quinidine alone |
| Pioro et al, 20107; 12-week, randomized, double-blind, placebo-controlled trial | 326 ALS and MS patients with clinically significant PBA | DMQ 30-10, DMQ 20-10, or placebo, given twice daily | CNC-LS scores decreased in all groups but the daily rate of PBA episodes was 47% lower for DMQ 30-10 and 49% lower for DMQ 20-10 compared with placebo |
| ALS: amyotrophic lateral sclerosis; CNC-LS: Center for Neurologic Study-Lability Scale; DM: dextromethorphan; DMQ 20-10: dextromethorphan, 20 mg, plus quinidine, 10 mg; DMQ 30-10: dextromethorphan, 30 mg, plus quinidine, 10 mg; DMQ 30-30: dextromethorphan, 30 mg, plus quinidine, 30 mg; MS: multiple sclerosis; PBA: pseudobulbar affect; QOL: quality of life; QOR: quality of relationships | |||
