Therapeutic use of dextromethorphan: Key learnings from treatment of pseudobulbar affect

Journal of the Neurological Sciences

Volumn 259, Issue 1-2, 2007, Pages 67-73

  Miller, Ariel ^a   Panitch, Hillel ^b  

^a CARMEL MEDICAL CENTER   (Israel)

^b UNIVERSITY OF VERMONT COLLEGE OF MEDICINE   (United States)

Author keywords

Amyotrophic lateral sclerosis; Crying; Emotion; Explosive; Laughing; Multiple sclerosis; Neuroprotection; Pseudobulbar effect

Indexed keywords

ANTITUSSIVE AGENT; BRAIN RECEPTOR; DEXTROMETHORPHAN; DEXTROMETHORPHAN PLUS QUINIDINE; DOPAMINE RECEPTOR STIMULATING AGENT; ENZYME INHIBITOR; PLACEBO; QUINIDINE; SEROTONIN UPTAKE INHIBITOR; TRICYCLIC ANTIDEPRESSANT AGENT; UNCLASSIFIED DRUG;

AMYOTROPHIC LATERAL SCLEROSIS; ARTICLE; BRAIN REGION; BRAIN STEM; CEREBELLUM; CLINICAL TRIAL; CRYING; DIZZINESS; DRUG ACTIVITY; DRUG EFFICACY; DRUG METABOLISM; DRUG SAFETY; EMOTION; EMOTIONAL DISORDER; HEADACHE; HUMAN; MENTAL DISEASE; MULTIPLE SCLEROSIS; NERVE CELL NETWORK; NEUROLOGIC DISEASE; NEUROPROTECTION; NONVERBAL COMMUNICATION; PATHOPHYSIOLOGY; PRIORITY JOURNAL; PSEUDOBULBAR AFFECT; SOMNOLENCE; TREATMENT OUTCOME;

ANIMALS; BRAIN; DEXTROMETHORPHAN; ENZYME INHIBITORS; EXCITATORY AMINO ACID ANTAGONISTS; HUMANS; MULTIPLE SCLEROSIS; PSEUDOBULBAR PALSY; QUINIDINE;

EID: 34447277189     PISSN: 0022510X     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.jns.2006.06.030     Document Type: Article

References (95)

1. Arciniegas D.B., and Topkoff J. The neuropsychiatry of pathologic affect: an approach to evaluation and treatment. Semin Clin Neuropsychiatry 5 (2000) 290-306
2. Poeck K. Pathological laughing and weeping in patients with progressive bulbar palsy. Ger Med Mon 14 (1969) 394-397
3. Feinstein A., Feinstein K., Gray T., and O'Connor P. Prevalence and neurobehavioral correlates of pathological laughing and crying in multiple sclerosis. Arch Neurol 54 (1997) 1116-1121
4. Lieberman A., and Benson D.F. Control of emotional expression in pseudobulbar palsy. A personal experience. Arch Neurol 34 (1977) 717-719
5. House A., Dennis M., Molyneux A., Warlow C., and Hawton K. Emotionalism after stroke. BMJ 298 (1989) 991-994
6. Darwin C. The expression of the emotions in man and animals (1872), D Appleton and Company, New York
7. Morris P.L., Robinson R.G., and Raphael B. Emotional lability after stroke. Aust N Z J Psychiatry 27 (1993) 601-605
8. Dark F.L., McGrath J.J., and Ron M.A. Pathological laughing and crying. Aust N Z J Psychiatry 30 (1996) 472-479
9. Arciniegas D.B., Lauterbach E.C., Anderson K.E., Chow T.W., Flashman L.A., Hurley R.A., et al. The differential diagnosis of pseudobulbar affect (PBA): distinguishing PBA among disorders of mood and affect. CNS Spectr 10 (2005) 1-14
10. Miller A. Pseudobulbar affect in multiple sclerosis: toward the development of innovative therapeutic strategies. J Neurol Sci 245 1-2 (2006) 153-159
11. Beck A.T., Ward C.H., Mendelson M., Mock J., and Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry 4 (1961) 561-571
12. Black K.J. Pathological laughing and crying. Am J Psychiatry 151 (1994) 456
13. Sato T., Bottlender R., Kleindienst N., and Moller H.J. Syndromes and phenomenological subtypes underlying acute mania: a factor analytic study of 576 manic patients. Am J Psychiatry 159 (2002) 968-974
14. Robertson G.M. Does mania include two distinct varieties of Insanity, and should it be sub-divided?. J Ment Sci 36 (1890) 338-347
15. Schiffer R.B., Herndon R.M., and Rudick R.A. Treatment of pathologic laughing and weeping with amitriptyline. N Engl J Med 312 (1985) 1480-1482
16. Robinson R.G., Parikh R.M., Lipsey J.R., Starkstein S.E., and Price T.R. Pathological laughing and crying following stroke: validation of a measurement scale and a double-blind treatment study. Am J Psychiatry 150 (1993) 286-293
17. Harvey P.D., Greenberg B.R., and Serper M.R. The affective lability scales: development, reliability, and validity. J Clin Psychol 45 (1989) 786-793
18. Starkstein S.E., Migliorelli R., Teson A., Petracca G., Chemerinsky E., and Manes F. Prevalence and clinical correlates of pathological affective display in Alzheimer's disease. J Neurol Neurosurg Psychiatry 59 (1995) 55-60
19. Tateno A., Jorge R.E., and Robinson R.G. Pathological laughing and crying following traumatic brain injury. J Neuropsychiatry Clin Neurosci 16 (2004) 426-434
20. Newsom-Davis I.C., Abrahams S., Goldstein L.H., and Leigh P.N. The emotional lability questionnaire: a new measure of emotional lability in amyotrophic lateral sclerosis. J Neurol Sci 169 (1999) 22-25
21. Moore S.R., Gresham L.S., Bromberg M.B., Kasarkis E.J., and Smith R.A. A self report measure of affective lability. J Neurol Neurosurg Psychiatry 63 (1997) 89-93
22. Smith R.A., Berg J.E., Pope L.E., Callahan J.D., Wynn D., and Thisted R.A. Validation off cns emotional liability scale for pseudobulbar affect (pathological laughing and crying) in multiple sclerosis patients. Mult Scler 10 (2004) 679-685
23. Wilson S.A.K. Some problems in neurology. II: Pathological laughing and crying. J Neurol Psychopathol IV (1924) 299-333
24. Ironside R. Disorders of laughter due to brain lesions. Brain 79 (1956) 589-609
25. Poeck K. Pathophysiology of emotional disorders associated with brain damage. In: Vinken P.J., and Bruyn G.W. (Eds). Handbook of clinical neurology (1969), American Elsevier Publishing Company, Inc., New York 343-367
26. Ceccaldi M., Poncet M., Milandre L., and Rouyer C. Temporary forced laughter after unilateral strokes. Eur Neurol 34 (1994) 36-39
27. Kim J.S. Pathological laughter and crying in unilateral stroke. Stroke 28 (1997) 2321
28. Kim J.S., and Choi-Kwon S. Poststroke depression and emotional incontinence: correlation with lesion location. Neurology 54 (2000) 1805-1810
29. Sackeim H.A., Greenberg M.S., Weiman A.L., Gur R.C., Hungerbuhler J.P., and Geschwind N. Hemispheric asymmetry in the expression of positive and negative emotions. Neurologic evidence. Arch Neurol 39 (1982) 210-218
30. Robinson R.G., Kubos K.L., Starr L.B., Rao K., and Price T.R. Mood changes in stroke patients: relationship to lesion location. Compr Psychiatry 24 (1983) 555-566
31. Robinson R.G., Kubos K.L., Starr L.B., Rao K., and Price T.R. Mood disorders in stroke patients. Importance of location of lesion. Brain 107 Pt 1 (1984) 81-93
32. Starkstein S.E., Robinson R.G., and Price T.R. Comparison of patients with and without poststroke major depression matched for size and location of lesion. Arch Gen Psychiatry 45 (1988) 247-252
33. Starkstein S.E., and Robinson R.G. Affective disorders and cerebral vascular disease. Br J Psychiatry 154 (1989) 170-182
34. Parvizi J., Anderson S.W., Martin C.O., Damasio H., and Damasio A.R. Pathological laughter and crying: a link to the cerebellum. Brain 124 (2001) 1708-1719
35. Okuda D.T., Chyung A.S., Chin C.T., and Waubant E. Acute pathological laughter. Mov Disord 20 (2005) 1389-1390
36. Lauterbach E.C., and Schweri M.M. Amelioration of pseudobulbar affect by fluoxetine: possible alteration of dopamine-related pathophysiology by a selective serotonin reuptake inhibitor. J Clin Psychopharmacol 11 (1991) 392-393
37. Brooks B.R., Thisted R.A., Appel S.H., Bradley W.G., Olney R.K., and Berg J.E. Treatment of pseudobulbar affect in ALS with dextromethorphan/quinidine: a randomized trial. Neurology 63 (2004) 1364-1370
38. Udaka F., Yamao S., Nagata H., Nakamura S., and Kameyama M. Pathologic laughing and crying treated with levodopa. Arch Neurol 41 (1984) 1095-1096
39. Andersen G., Vestergaard K., and Riis J.O. Citalopram for post-stroke pathological crying. Lancet 342 (1993) 837-839
40. Burns A., Russell E., Stratton-Powell H., Tyrell P., O'Neill P., and Baldwin R. Sertraline in stroke-associated lability of mood. Int J Geriatr Psychiatry 14 (1999) 681-685
41. Muller U., Murai T., Bauer-Wittmund T., and von Cramon D.Y. Paroxetine versus citalopram treatment of pathological crying after brain injury. Brain Inj 13 (1999) 805-811
42. Schiffer R., and Pope L.E. Review of pseudobulbar affect including a novel and new potential therapy (2005)
43. Pollock B.G., Mulsant B.H., Nebes R., Kirshner M.A., Begley A.E., and Mazumdar S. Serum anticholinergicity in elderly depressed patients treated with paroxetine or nortriptyline. Am J Psychiatry 155 (1998) 1110-1112
44. Baldessarini R.J. Drugs and the treatment of psychiatric disorders: depression and anxiety disorders. In: Hardman J.G., Limbird L.E., and Gilman A.G. (Eds). Goodman and Gilman's the pharmacological basis of therapeutics (2001), The McGraw-Hill Companies, Inc., New York 447-483
45. Zhang Y., Britto M.R., Valderhaug K.L., Wedlund P.J., and Smith R.A. Dextromethorphan: enhancing its systemic availability by way of low-dose quinidine-mediated inhibition of cytochrome P4502D6. Clin Pharmacol Ther 51 (1992) 647-655
46. Palmer G.C. Neuroprotection by NMDA receptor antagonists in a variety of neuropathologies. Curr Drug Targets 2 (2001) 241-271
47. Liu Y., Qin L., Li G., Zhang W., An L., and Liu B. Dextromethorphan protects dopaminergic neurons against inflammation-mediated degeneration through inhibition of microglial activation. J Pharmacol Exp Ther 305 (2003) 212-218
48. Wills R.J., and Martin K.S. Dextromethorphan/dextrorphan disposition in rat plasma and brain. Pharm Res 5 (1988) 193S
49. Tortella F.C., Martin D.A., Allot C.P., Steel J.A., Blackburn T.P., and Loveday B.E. Dextromethorphan attenuates post-ischemic hypoperfusion following incomplete global ischemia in the anesthetized rat. Brain Res 482 (1989) 179-183
50. Tortella F.C., Davey R., Pellicano M., and Bowery N.G. Autoradiographic localization of 3H-dextromethorphan binding sites differs from NMDA. NIDA Res Monogr 95 (1989) 548-549
51. Tortella F.C., Pellicano M., and Bowery N.G. Dextromethorphan and neuromodulation: old drug coughs up new activities. Trends Pharmacol Sci 10 (1989) 501-507
52. Klein M., and Musacchio J.M. High affinity dextromethorphan binding sites in guinea pig brain. Effect of sigma ligands and other agents. J Pharmacol Exp Ther 251 (1989) 207-215
53. Maurice T., and Lockhart B.P. Neuroprotective and anti-amnesic potentials of sigma (sigma) receptor ligands. Prog Neuropsychopharmacol Biol Psychiatry 21 (1997) 69-102
54. Ebert B., Thorkildsen C., Andersen S., Christrup L.L., and Hjeds H. Opioid analgesics as noncompetitive N-methyl-d-aspartate (NMDA) antagonists. Biochem Pharmacol 56 (1998) 553-559
55. Maurice T., Urani A., Phan V.L., and Romieu P. The interaction between neuroactive steroids and the sigma1 receptor function: behavioral consequences and therapeutic opportunities. Brain Res Brain Res Rev 37 (2001) 116-132
56. Musacchio J.M., Klein M., and Canoll P.D. Dextromethorphan and sigma ligands: common sites but diverse effects. Life Sci 45 (1989) 1721-1732
57. Blin O., Azulay J.P., Desnuelle C., Bille-Turc F., Braguer D., and Besse D. A controlled one-year trial of dextromethorphan in amyotrophic lateral sclerosis. Clin Neuropharmacol 19 (1996) 189-192
58. Gredal O., Werdelin L., Bak S., Christensen P.B., Boysen G., and Kristensen M.O. A clinical trial of dextromethorphan in amyotrophic lateral sclerosis. Acta Neurol Scand 96 (1997) 8-13
59. Walker F.O., and Hunt V.P. An open label trial of dextromethorphan in Huntington's disease. Clin Neuropharmacol 12 (1989) 322-330
60. Chase T.N., Oh J.D., and Konitsiotis S. Antiparkinsonian and antidyskinetic activity of drugs targeting central glutamatergic mechanisms. J Neurol 247 Suppl 2 (2000) II36-II42
61. McQuay H.J., Carroll D., Jadad A.R., Glynn C.J., Jack T., and Moore R.A. Dextromethorphan for the treatment of neuropathic pain: a double-blind randomised controlled crossover trial with integral n-of-1 design. Pain 59 (1994) 127-133
62. Vinik A.I. Diabetic neuropathy: pathogenesis and therapy. Am J Med 107 (1999) 17S-26S
63. Sang C.N. NMDA-receptor antagonists in neuropathic pain: experimental methods to clinical trials. J Pain Symptom Manage 19 (2000) S21-S25
64. Weinbroum A.A., Rudick V., Paret G., and Ben Abraham R. The role of dextromethorphan in pain control. Can J Anaesth 47 (2000) 585-596
65. Ben Abraham R., Marouani N., Kollender Y., Meller I., and Weinbroum A.A. Dextromethorphan for phantom pain attenuation in cancer amputees: a double-blind crossover trial involving three patients. Clin J Pain 18 (2002) 282-285
66. Heiskanen T., Hartel B., Dahl M.L., Seppala T., and Kalso E. Analgesic effects of dextromethorphan and morphine in patients with chronic pain. Pain 96 (2002) 261-267
67. Sang C.N., Booher S., Gilron I., Parada S., and Max M.B. Dextromethorphan and memantine in painful diabetic neuropathy and postherpetic neuralgia: efficacy and dose-response trials. Anesthesiology 96 (2002) 1053-1061
68. Pope L.E., Khalil M.H., Berg J.E., Stiles M., Yakatan G.J., and Sellers E.M. Pharmacokinetics of dextromethorphan after single or multiple dosing in combination with quinidine in extensive and poor metabolizers. J Clin Pharmacol 44 (2004) 1132-1142
69. Vetticaden S.J., Cabana B.E., Prasad V.K., Purich E.D., Jonkman J.H., and de Zeeuw R. Phenotypic differences in dextromethorphan metabolism. Pharm Res 6 (1989) 13-19
70. Brinn R., Brosen K., Gram L.F., Haghfelt T., and Otton S.V. Sparteine oxidation is practically abolished in quinidine-treated patients. Br J Clin Pharmacol 22 (1986) 194-197
71. Inaba T., Tyndale R.E., and Mahon W.A. Quinidine: potent inhibition of sparteine and debrisoquine oxidation in vivo. Br J Clin Pharmacol 22 (1986) 199-200
72. Leemann T., Dayer P., and Meyer U.A. Single-dose quinidine treatment inhibits metoprolol oxidation in extensive metabolizers. Eur J Clin Pharmacol 29 (1986) 739-741
73. Mikus G., Ha H.R., Vozeh S., Zekorn C., Follath F., and Eichelbaum M. Pharmacokinetics and metabolism of quinidine in extensive and poor metabolisers of sparteine. Eur J Clin Pharmacol 31 (1986) 69-72
74. Brosen K., Gram L.F., Haghfelt T., and Bertilsson L. Extensive metabolizers of debrisoquine become poor metabolizers during quinidine treatment. Pharmacol Toxicol 60 (1987) 312-314
75. Broly F., Libersa C., Lhermitte M., Bechtel P., and Dupuis B. Effect of quinidine on the dextromethorphan O-demethylase activity of microsomal fractions from human liver. Br J Clin Pharmacol 28 (1989) 29-36
76. Roden D.M. Antiarrhythmic drugs. In: Hardman J.G., Limbird L.E., Molinoff P.B., Ruddon R.W., and Gilman A.G. (Eds). Goodman and Gilman's the pharmacological basis of therapeutics (1996), McGraw-Hill, New York 839-874
77. Panitch H.S., Thisted R.A., Wynn D.R., Wymer J.P., Achiron A., and Miller A. Dextromethorphan/quinidine for pseudobulbar affect in multiple sclerosis. Ann Neurol 59 5 (2006) 780-787
78. Desmeules J.A., Oestreicher M.K., Piguet V., Allaz A.F., and Dayer P. Contribution of cytochrome P-4502D6 phenotype to the neuromodulatory effects of dextromethorphan. J Pharmacol Exp Ther 288 (1999) 607-612
79. Choi D.W., Peters S., and Viseskul V. Dextrorphan and levorphanol selectively block N-methyl-d-aspartate receptor-mediated neurotoxicity on cortical neurons. J Pharmacol Exp Ther 242 (1987) 713-720
80. Chapman A.G., and Meldrum B.S. Non-competitive N-methyl-d-aspartate antagonists protect against sound-induced seizures in DBA/2 mice. Eur J Pharmacol 166 (1989) 201-211
81. Yamamoto H., Yamamoto T., Sagi N., Klenerova V., Goji K., and Kawai N. Sigma ligands indirectly modulate the NMDA receptor-ion channel complex on intact neuronal cells via sigma 1 site. J Neurosci 15 (1995) 731-736
82. Lipton S.A. Prospects for clinically tolerated NMDA antagonists: open-channel blockers and alternative redox states of nitric oxide. Trends Neurosci 16 (1993) 527-532
83. Ankarcrona M., Dypbukt J.M., Bonfoco E., Zhivotovsky B., Orrenius S., and Lipton S.A. Glutamate-induced neuronal death: a succession of necrosis or apoptosis depending on mitochondrial function. Neuron 15 (1995) 961-973
84. Bittigau P., and Ikonomidou C. Glutamate in neurologic diseases. J Child Neurol 12 (1997) 471-485
85. Parsons C.G., Danysz W., and Quack G. Glutamate in CNS disorders as a target for drug development: an update. Drug News Perspect 11 (1998) 523-569
86. Olney J.W., and de Gubareff T. Glutamate neurotoxicity and Huntington's chorea. Nature 271 (1978) 557-559
87. Seif E.N., Peruche B., Rossberg C., Mennel H.D., and Krieglstein J. Neuroprotective effect of memantine demonstrated in vivo and in vitro. Eur J Pharmacol 185 (1990) 19-24
88. DeCoster M.A., Klette K.L., Knight E.S., and Tortella F.C. Sigma receptor-mediated neuroprotection against glutamate toxicity in primary rat neuronal cultures. Brain Res 671 (1995) 45-53
89. Monyer H., and Choi D.W. Morphinans attenuate cortical neuronal injury induced by glucose deprivation in vitro. Brain Res 446 (1988) 144-148
90. Radek R.J., and Giardina W.J. The neuroprotective effects of dextromethorphan on guinea pig-derived hippocampal slices during hypoxia. Neurosci Lett 139 (1992) 191-193
91. Luhmann H.J., and Scheid M. Dextromethorphan attenuates hypoxia-induced neuronal dysfunction in rat neocortical slices. Neurosci Lett 178 (1994) 171-174
92. Steinberg G.K., George C.P., DeLaPaz R., Shibata D.K., and Gross T. Dextromethorphan protects against cerebral injury following transient focal ischemia in rabbits. Stroke 19 (1988) 1112-1118
93. Prince D.A., and Feeser H.R. Dextromethorphan protects against cerebral infarction in a rat model of hypoxia-ischemia. Neurosci Lett 85 (1988) 291-296
94. Bokesch P.M., Marchand J.E., Connelly C.S., Wurm W.H., and Kream R.M. Dextromethorphan inhibits ischemia-induced c-fos expression and delayed neuronal death in hippocampal neurons. Anesthesiology 81 (1994) 470-477
95. Golding E.M., and Vink R. Efficacy of competitive vs noncompetitive blockade of the NMDA channel following traumatic brain injury. Mol Chem Neuropathol 24 (1995) 137-150