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Dextromethorphan/quinidine: in pseudobulbar affect.
CNS Drugs. 2011 May; 25(5):435-45.CD

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.

Authors+Show Affiliations

Adis, a Wolters Kluwer Business, Auckland, New Zealand. demail@adis.co.nz

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

21476614

Citation

Garnock-Jones, Karly P.. "Dextromethorphan/quinidine: in Pseudobulbar Affect." CNS Drugs, vol. 25, no. 5, 2011, pp. 435-45.
Garnock-Jones KP. Dextromethorphan/quinidine: in pseudobulbar affect. CNS Drugs. 2011;25(5):435-45.
Garnock-Jones, K. P. (2011). Dextromethorphan/quinidine: in pseudobulbar affect. CNS Drugs, 25(5), 435-45. https://doi.org/10.2165/11207260-000000000-00000
Garnock-Jones KP. Dextromethorphan/quinidine: in Pseudobulbar Affect. CNS Drugs. 2011;25(5):435-45. PubMed PMID: 21476614.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dextromethorphan/quinidine: in pseudobulbar affect. A1 - Garnock-Jones,Karly P, PY - 2011/4/12/entrez PY - 2011/4/12/pubmed PY - 2011/7/28/medline SP - 435 EP - 45 JF - CNS drugs JO - CNS Drugs VL - 25 IS - 5 N2 - 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. SN - 1179-1934 UR - https://www.unboundmedicine.com/medline/citation/21476614/Dextromethorphan/quinidine:_in_pseudobulbar_affect_ L2 - https://dx.doi.org/10.2165/11207260-000000000-00000 DB - PRIME DP - Unbound Medicine ER -