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Randomized, controlled trial of dextromethorphan/quinidine for pseudobulbar affect in multiple sclerosis.
Ann Neurol. 2006 May; 59(5):780-7.AN

Abstract

OBJECTIVE

To evaluate the efficacy and safety of DM/Q (capsules containing dextromethorphan [DM] and quinidine [Q]) compared with placebo, taken twice daily, for the treatment of pseudobulbar affect over a 12-week period in multiple sclerosis patients.

METHODS

A total of 150 patients were randomized in a double-blind, placebo-controlled study to assess pseudobulbar affect with the validated Center for Neurologic Study-Lability Scale. Each patient also recorded the number of episodes experienced between visits, estimated quality of life and quality of relationships on visual analog scales, and completed a pain rating scale.

RESULTS

Patients receiving DM/Q had greater reductions in Center for Neurologic Study-Lability Scale scores than those receiving placebo (p < 0.0001) at all clinic visits (days 15, 29, 57, and 85). All secondary end points also favored DM/Q, including the number of crying or laughing episodes (p <or= 0.0077), quality of life (p < 0.0001), quality of relationships (p = 0.0001), and pain intensity score (p = 0.0271). DM/Q was well tolerated; only dizziness occurred with greater frequency than with placebo.

INTERPRETATION

Results in multiple sclerosis patients were similar to those of a previous study in amyotrophic lateral sclerosis, demonstrating that DM/Q may be beneficial in treating potentially disabling pseudobulbar affect in a variety of neurological disorders.

Authors+Show Affiliations

Neurology Health Care Service, Fletcher Allen Health Care, University of Vermont, Burlington, 05401, USA. hillel.panitch@vtmednet.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16634036

Citation

Panitch, Hillel S., et al. "Randomized, Controlled Trial of Dextromethorphan/quinidine for Pseudobulbar Affect in Multiple Sclerosis." Annals of Neurology, vol. 59, no. 5, 2006, pp. 780-7.
Panitch HS, Thisted RA, Smith RA, et al. Randomized, controlled trial of dextromethorphan/quinidine for pseudobulbar affect in multiple sclerosis. Ann Neurol. 2006;59(5):780-7.
Panitch, H. S., Thisted, R. A., Smith, R. A., Wynn, D. R., Wymer, J. P., Achiron, A., Vollmer, T. L., Mandler, R. N., Dietrich, D. W., Fletcher, M., Pope, L. E., Berg, J. E., & Miller, A. (2006). Randomized, controlled trial of dextromethorphan/quinidine for pseudobulbar affect in multiple sclerosis. Annals of Neurology, 59(5), 780-7.
Panitch HS, et al. Randomized, Controlled Trial of Dextromethorphan/quinidine for Pseudobulbar Affect in Multiple Sclerosis. Ann Neurol. 2006;59(5):780-7. PubMed PMID: 16634036.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Randomized, controlled trial of dextromethorphan/quinidine for pseudobulbar affect in multiple sclerosis. AU - Panitch,Hillel S, AU - Thisted,Ronald A, AU - Smith,Richard A, AU - Wynn,Daniel R, AU - Wymer,James P, AU - Achiron,Anat, AU - Vollmer,Timothy L, AU - Mandler,Raul N, AU - Dietrich,Dennis W, AU - Fletcher,Malcolm, AU - Pope,Laura E, AU - Berg,James E, AU - Miller,Ariel, AU - ,, PY - 2006/4/25/pubmed PY - 2006/6/15/medline PY - 2006/4/25/entrez SP - 780 EP - 7 JF - Annals of neurology JO - Ann. Neurol. VL - 59 IS - 5 N2 - OBJECTIVE: To evaluate the efficacy and safety of DM/Q (capsules containing dextromethorphan [DM] and quinidine [Q]) compared with placebo, taken twice daily, for the treatment of pseudobulbar affect over a 12-week period in multiple sclerosis patients. METHODS: A total of 150 patients were randomized in a double-blind, placebo-controlled study to assess pseudobulbar affect with the validated Center for Neurologic Study-Lability Scale. Each patient also recorded the number of episodes experienced between visits, estimated quality of life and quality of relationships on visual analog scales, and completed a pain rating scale. RESULTS: Patients receiving DM/Q had greater reductions in Center for Neurologic Study-Lability Scale scores than those receiving placebo (p < 0.0001) at all clinic visits (days 15, 29, 57, and 85). All secondary end points also favored DM/Q, including the number of crying or laughing episodes (p <or= 0.0077), quality of life (p < 0.0001), quality of relationships (p = 0.0001), and pain intensity score (p = 0.0271). DM/Q was well tolerated; only dizziness occurred with greater frequency than with placebo. INTERPRETATION: Results in multiple sclerosis patients were similar to those of a previous study in amyotrophic lateral sclerosis, demonstrating that DM/Q may be beneficial in treating potentially disabling pseudobulbar affect in a variety of neurological disorders. SN - 0364-5134 UR - https://www.unboundmedicine.com/medline/citation/16634036/Randomized_controlled_trial_of_dextromethorphan/quinidine_for_pseudobulbar_affect_in_multiple_sclerosis_ L2 - https://doi.org/10.1002/ana.20828 DB - PRIME DP - Unbound Medicine ER -