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Related Experiment Videos

Randomized, controlled trial of dextromethorphan/quinidine for pseudobulbar affect in multiple sclerosis.

Hillel S Panitch1, Ronald A Thisted, Richard A Smith

  • 1Neurology Health Care Service, Fletcher Allen Health Care, University of Vermont, Burlington, 05401, USA. hillel.panitch@vtmednet.org

Annals of Neurology
|April 25, 2006
PubMed
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This summary is machine-generated.

Dextromethorphan/quinidine (DM/Q) significantly reduced pseudobulbar affect symptoms in multiple sclerosis patients. This treatment improved quality of life and relationships, with only mild side effects like dizziness.

Area of Science:

  • Neurology
  • Psychiatry

Background:

  • Pseudobulbar affect (PBA) is characterized by involuntary emotional outbursts.
  • PBA can significantly impair quality of life in patients with neurological disorders.
  • Multiple sclerosis (MS) is a common neurological condition associated with PBA.

Purpose of the Study:

  • To assess the efficacy and safety of dextromethorphan/quinidine (DM/Q) for treating PBA in MS patients.
  • To compare DM/Q with a placebo over a 12-week treatment period.
  • To evaluate the impact of DM/Q on emotional lability, quality of life, relationships, and pain.

Main Methods:

  • A double-blind, placebo-controlled study randomized 150 MS patients.
  • Participants received either DM/Q or placebo twice daily.
  • Outcomes were measured using the Center for Neurologic Study-Lability Scale (CNSL), episode logs, visual analog scales (VAS) for quality of life and relationships, and a pain rating scale.

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Main Results:

  • DM/Q demonstrated statistically significant reductions in CNSL scores compared to placebo at all measured time points (p < 0.0001).
  • Secondary endpoints, including reduced crying/laughing episodes (p ≤ 0.0077), improved quality of life (p < 0.0001), enhanced relationships (p = 0.0001), and decreased pain intensity (p = 0.0271), favored DM/Q.
  • DM/Q was generally well-tolerated, with dizziness being the most frequent adverse event reported more often than with placebo.

Conclusions:

  • DM/Q is an effective treatment for pseudobulbar affect in multiple sclerosis patients.
  • The findings are consistent with previous research in amyotrophic lateral sclerosis (ALS).
  • DM/Q shows potential as a beneficial therapy for disabling PBA across various neurological conditions.