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Dextromethorphan/quinidine: a review of its use in adults with pseudobulbar affect.
Drugs. 2015 Jan; 75(1):83-90.D

Abstract

Fixed-dose dextromethorphan/quinidine capsules (Nuedexta(®)) utilize quinidine to inhibit the metabolism of dextromethorphan, enabling high plasma dextromethorphan concentrations to be reached without using a larger dose of the drug. The drug combination is the first treatment to be approved for pseudobulbar affect (PBA), a condition of contextually inappropriate/exaggerated emotional expression that often occurs in adults with neurological damage conditions, such as amyotrophic lateral sclerosis (ALS), multiple sclerosis (MS), stroke, traumatic brain injury, Alzheimer's disease or Parkinson's disease. Dextromethorphan/quinidine at the recommended dosages of 20/10 or 30/10 mg twice daily reduced the rate of PBA episodes and improved PBA severity in a 12-week, double-blind, placebo-controlled trial in adults with ALS or MS (STAR), with further improvements in the severity of the condition observed in a 12-week open-label extension phase. Dextromethorphan/quinidine 20/10 mg twice daily also improved PBA secondary to dementia in a cohort of a 12-week noncomparative trial (PRISM II). The drug combination was generally well tolerated in these studies, with no particular safety or tolerability concerns. Although longer-term efficacy and tolerability data for dextromethorphan/quinidine 20/10 or 30/10 mg twice daily would be beneficial, current evidence indicates that it is a useful option in the treatment of adults with PBA.

Authors+Show Affiliations

Springer, Private Bag 65901, Mairangi Bay 0754, Auckland, New Zealand.No affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

25420446

Citation

Yang, Lily P H., and Emma D. Deeks. "Dextromethorphan/quinidine: a Review of Its Use in Adults With Pseudobulbar Affect." Drugs, vol. 75, no. 1, 2015, pp. 83-90.
Yang LP, Deeks ED. Dextromethorphan/quinidine: a review of its use in adults with pseudobulbar affect. Drugs. 2015;75(1):83-90.
Yang, L. P., & Deeks, E. D. (2015). Dextromethorphan/quinidine: a review of its use in adults with pseudobulbar affect. Drugs, 75(1), 83-90. https://doi.org/10.1007/s40265-014-0328-z
Yang LP, Deeks ED. Dextromethorphan/quinidine: a Review of Its Use in Adults With Pseudobulbar Affect. Drugs. 2015;75(1):83-90. PubMed PMID: 25420446.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dextromethorphan/quinidine: a review of its use in adults with pseudobulbar affect. AU - Yang,Lily P H, AU - Deeks,Emma D, PY - 2014/11/26/entrez PY - 2014/11/26/pubmed PY - 2015/9/15/medline SP - 83 EP - 90 JF - Drugs JO - Drugs VL - 75 IS - 1 N2 - Fixed-dose dextromethorphan/quinidine capsules (Nuedexta(®)) utilize quinidine to inhibit the metabolism of dextromethorphan, enabling high plasma dextromethorphan concentrations to be reached without using a larger dose of the drug. The drug combination is the first treatment to be approved for pseudobulbar affect (PBA), a condition of contextually inappropriate/exaggerated emotional expression that often occurs in adults with neurological damage conditions, such as amyotrophic lateral sclerosis (ALS), multiple sclerosis (MS), stroke, traumatic brain injury, Alzheimer's disease or Parkinson's disease. Dextromethorphan/quinidine at the recommended dosages of 20/10 or 30/10 mg twice daily reduced the rate of PBA episodes and improved PBA severity in a 12-week, double-blind, placebo-controlled trial in adults with ALS or MS (STAR), with further improvements in the severity of the condition observed in a 12-week open-label extension phase. Dextromethorphan/quinidine 20/10 mg twice daily also improved PBA secondary to dementia in a cohort of a 12-week noncomparative trial (PRISM II). The drug combination was generally well tolerated in these studies, with no particular safety or tolerability concerns. Although longer-term efficacy and tolerability data for dextromethorphan/quinidine 20/10 or 30/10 mg twice daily would be beneficial, current evidence indicates that it is a useful option in the treatment of adults with PBA. SN - 1179-1950 UR - https://www.unboundmedicine.com/medline/citation/25420446/Dextromethorphan/quinidine:_a_review_of_its_use_in_adults_with_pseudobulbar_affect_ L2 - https://dx.doi.org/10.1007/s40265-014-0328-z DB - PRIME DP - Unbound Medicine ER -