Dextromethorphan/Quinidine: In pseudobulbar affect

CNS Drugs

Volumn 25, Issue 5, 2011, Pages 435-445

  Garnock Jones, Karly P ^a  

^a ADIS INTERNATIONAL LIMITED   (New Zealand)

Author keywords

Adis Drug Profiles; Amyotrophic lateral sclerosis; Dextromethorphan; Emotional lability; Multiple sclerosis; Quinidine

Indexed keywords

3 HYDROXYQUINIDINE; DEXTROMETHORPHAN; DEXTROMETHORPHAN PLUS QUINIDINE; DEXTRORPHAN; DIGOXIN; MEMANTINE; MONOAMINE OXIDASE INHIBITOR; NUEDEXTA; PAROXETINE; PLACEBO; QUINIDINE; SEROTONIN UPTAKE INHIBITOR; UNCLASSIFIED DRUG;

ABDOMINAL PAIN; AMYOTROPHIC LATERAL SCLEROSIS; AREA UNDER THE CURVE; ARTICLE; ASTHENIA; ATAXIA; CHRONIC PAIN; CINCHONISM; COLOR VISION; CONSTIPATION; CONVULSION; DEPRESSION; DIARRHEA; DIZZINESS; DOSE RESPONSE; DROWSINESS; DRUG ABSORPTION; DRUG DISTRIBUTION; DRUG DOSE INCREASE; DRUG EFFICACY; DRUG ELIMINATION; DRUG HALF LIFE; DRUG HYPERSENSITIVITY; DRUG INDUCED HEADACHE; DRUG INTOXICATION; DRUG MECHANISM; DRUG METABOLISM; DRUG SAFETY; DRUG TOLERABILITY; DRUG WITHDRAWAL; DYSPHAGIA; EMOTIONAL INCONTINENCE; FALLING; FATIGUE; HEPATITIS; HUMAN; KERATOPATHY; KIDNEY DYSFUNCTION; MAXIMUM PLASMA CONCENTRATION; MENTAL INSTABILITY; MULTICENTER STUDY (TOPIC); MULTIPLE SCLEROSIS; MUSCLE SPASM; MYDRIASIS; NAUSEA; NERVOUSNESS; NIGHT BLINDNESS; OPTIC NEURITIS; PATHOLOGICAL CRYING; PATHOLOGICAL LAUGHTER; PHOTOSENSITIVITY; PIGMENT DISORDER; PRIORITY JOURNAL; PSEUDOBULBAR AFFECT; PSYCHOSIS; QT PROLONGATION; RANDOMIZED CONTROLLED TRIAL (TOPIC); RECOMMENDED DRUG DOSE; RESPIRATION DEPRESSION; RESTLESSNESS; RHINOPHARYNGITIS; SEROTONIN SYNDROME; SIDE EFFECT; SOMNOLENCE; SPASTICITY; STOMACH PAIN; THROMBOCYTOPENIA; TIME TO MAXIMUM PLASMA CONCENTRATION; VISUAL FIELD DEFECT; VOMITING;

AMYOTROPHIC LATERAL SCLEROSIS; CRYING; DEXTROMETHORPHAN; DRUG COMBINATIONS; EMOTIONS; FEMALE; HUMANS; LAUGHTER; MALE; MOOD DISORDERS; MULTIPLE SCLEROSIS; QUINIDINE;

EID: 79953869333     PISSN: 11727047     EISSN: 11791934     Source Type: Journal    
DOI: 10.2165/11207260-000000000-00000     Document Type: Article

References (23)

1. Rosen HJ, Cummings J. A real reason for patients with pseudobulbar affect to smile. Ann Neurol 2007 Feb; 61 (2): 92-6 (Pubitemid 46363836)
2. Miller A. Pseudobulbar affect in multiple sclerosis: toward the development of innovative therapeutic strategies. J Neurol Sci 2006 Jun 15; 245 (1-2): 153-9 (Pubitemid 43792408)
3. Wortzel HS, Oster TJ, Anderson CA, et al. Pathological laughing and crying: epidemiology, pathophysiology and treatment. CNS Drugs 2008; 22 (7): 531-45 (Pubitemid 351822116)
4. Wynn D, Kaye R, Hepner A. Impact of pseudobulbar affect on health and QoL [abstract no. M-38 plus poster]. 135th Annual Meeting of the American Neurological Association; 2010 Sep 12-15; San Fransisco (CA)
5. Martin CM. It's nothing to laugh about: understanding disorders of emotional expression. Consult Pharm 2007 Sep; 22 (9): 732-42 (Pubitemid 47438721)
6. Strowd RE, Cartwright MS, Okun MS, et al. Pseudobulbar affect: prevalence and quality of life impact in movement disorders. J Neurol 2010 Aug; 257 (8): 1382-7
7. Rabins PV, Arciniegas DB. Pathophysiology of involuntary emotional expression disorder. CNS Spectr 2007 Apr; 12 (4 Suppl. 5): 17-22 (Pubitemid 46709312)
8. Avanir Pharmaceuticals, Inc. Nuedexta™ (dextromethorphan hydrobromide and quinidine sulfate capsules) US prescribing information [online]. Available from URL: http://www.nuedexta.com/NUEDEXTA-Full-Prescribing- Information-1.pdf [Accessed 2011 Mar 28] (Pubitemid 43673155)
9. Brooks BR, Thisted RA, Appel SH, et al. Treatment of pseudobulbar affect in ALS with dextromethorphan/ quinidine: a randomized trial. Neurology 2004 Oct 26; 63 (8): 1364-70 (Pubitemid 39426266)
10. Pioro EP, Brooks BR, Cummings J, et al. Dextromethorphan plus ultra low-dose quinidine reduces pseudobulbar affect. Ann Neurol 2010 Nov; 68 (5): 693-702
11. Haiman G, Pratt H, Miller A. Effects of dextromethorphan/ quinidine on auditory event-related potentials in multiple sclerosis patients with pseudobulbar affect. J Clin Psychopharmacol 2009 Oct; 29 (5): 444-52
12. Werling LL, Keller A, Frank JG, et al. A comparison of the binding profiles of dextromethorphan, memantine, fluoxetine and amitriptyline: treatment of involuntary emotional expression disorder. Exp Neurol 2007 Oct; 207 (2): 248-57 (Pubitemid 47429659)
13. Werling LL, Lauterbach EC, Calef U. Dextromethorphan as a potential neuroprotective agent with unique mechanisms of action. Neurologist 2007 Sep; 13 (5): 272-93 (Pubitemid 47396313)
14. Rosen H. Dextromethorphan/quinidine sulfate for pseudo-bulbar affect. Drugs Today (Barc) 2008 Sep; 44 (9): 661-8
15. Zawertailo LA, Tyndale RF, Busto U, et al. Effect of me-tabolic blockade on the psychoactive effects of dextro-methorphan. Hum Psychopharmacol 2010 Jan; 25 (1): 71-9
16. Moghadamnia AA, Rostami-Hodjegan A, Abdul-Manap R, et al. Physiologically based modelling of inhibition of metabolism and assessment of the relative potency of drug and metabolite: dextromethorphan vs. dextrorphan using quinidine inhibition. Br J Clin Pharmacol 2003 Jul; 56 (1): 57-67 (Pubitemid 36886489)
17. Capon DA, Bochner F, Kerry N, et al. The influence of CYP2D6 polymorphism and quinidine on the disposition and antitussive effect of dextromethorphan in humans. Clin Pharmacol Ther 1996 Sep; 60 (3): 295-307 (Pubitemid 26354450)
18. Pope LE, Khalil MH, Berg JE, et al. Pharmacokinetics of dextromethorphan after single or multiple dosing in combination with quinidine in extensive and poor metabolizers. J Clin Pharmacol 2004 Oct; 44 (10): 1132-42 (Pubitemid 39202458)
19. Schadel M, Wu D, Otton SV, et al. Pharmacokinetics of dextromethorphan and metabolites in humans: influence of the CYP2D6 phenotype and quinidine inhibition. J Clin Psychopharmacol 1995 Aug; 15 (4): 263-9
20. Pope L, Kaye R, Hepner A, et al. A study of potential pharmacokinetic (PK) and pharmacodynamic (PD) interactions between dextromethorphan/quinidine and mem-antine [abstract no. NR3-27]. 163rd Annual Meeting of the American Psychiatric Association; 2010 May 22-26; New Orleans (LA)
21. Pioro E, Brooks B, Cummings J, et al. Persistent efficacy of dextromethorphan (DM)/quinidine (Q) for pseudobulbar affect (PBA): results from a 12-week, open-label extension (OLE) study [abstract no. LBS.006]. Neurology 2010 Jul; 75 (4): 380
22. Brooks BR, Cummings J, Pioro EP, et al. Star trial: subanalysis of an international, multi-center, placebo-controlled study of AVP-923 (dextromethorphan/quinidine) for the treatment of pseudobulbar affect (PBA) in amyotrophic lateral sclerosis (ALS) patients [abstract no. C41 plus oral presentation]. 20th International Symposium on Amyo-trophic Lateral Sclerosis/Motor Neurone Disease; 2009 Dec 8-12; Berlin
23. Wynn D, Schiffer R, Brooks BR, et al. Double-blind, placebo-controlled, multinational study of dextromethorphan/ quinidine for psuedobulbar affect in multiple sclerosis [abstract no. S150 plus poster]. 24th Annual Meeting of the Consortium of Multiple Sclerosis Centers; 2010 Jun 2-5; San Antonio (TX)