Involuntary emotional expression disorder: treating the untreated

Area of Science:

• Neurology
• Psychiatry

Background:

• Involuntary emotional expression disorder (IEED) significantly impairs social and occupational functioning.
• No Food and Drug Administration-approved treatments currently exist for IEED.

Purpose of the Study:

• To review current treatment options for IEED, including monaminergic agents and dextromethorphan/quinidine.
• To evaluate the efficacy and tolerability of existing IEED treatments.

Main Methods:

• Review of studies on tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), dopaminergic agents, and dextromethorphan/quinidine.
• Analysis of assessment measures for symptomatic improvement and clinical condition.
• Examination of tolerability profiles and side effects.

Main Results:

• Monaminergic agents and dextromethorphan/quinidine demonstrate symptomatic improvements, including reduced emotional episodes.
• TCAs and SSRIs have defined side effect profiles (e.g., dizziness, QTc prolongation, sexual dysfunction).
• Dextromethorphan/quinidine showed significant improvements in symptoms, quality of life, and relationships in large multicenter studies, with common side effects of dizziness and nausea.

Conclusions:

• Treatment choice for IEED should be evidence-based, balancing efficacy with patient tolerability.
• Further research may be needed to optimize IEED management.
• Dextromethorphan/quinidine presents a promising option, though potential drug interactions require consideration.