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Pathological laughing and crying : epidemiology, pathophysiology and treatment
Hal S Wortzel1, Timothy J Oster, C Alan Anderson
1Brain Injury Rehabilitation Unit, HealthONE Spalding Rehabilitation Hospital, Aurora, Colorado, USA.
CNS Drugs
|June 13, 2008
Summary
Pathological laughing and crying (PLC) is a neurological disorder causing uncontrollable emotional outbursts. Selective serotonin reuptake inhibitors (SSRIs) are recommended as the primary treatment for this condition.
Area of Science:
- Neurology
- Neuroscience
- Psychiatry
Background:
- Pathological laughing and crying (PLC) involves frequent, intense episodes of uncontrollable crying or laughing.
- This neurological disorder can significantly impair daily activities and cause distress.
- PLC is often misunderstood and under-recognized by clinicians and families.
Purpose of the Study:
- To provide clear definitions distinguishing mood and affect disorders.
- To review the clinical features, epidemiology, and pathophysiology of PLC.
- To guide the diagnosis and treatment of patients experiencing PLC.
Main Methods:
- Review of literature on mood and affect disorders.
- Analysis of clinical features and epidemiological data for PLC.
- Examination of neuroanatomic and neurochemical bases of PLC.
- Evaluation of published treatment studies for PLC.
Main Results:
- Selective serotonin reuptake inhibitors (SSRIs) are recommended as first-line pharmacotherapy.
- Other agents like TCAs, noradrenergic reuptake inhibitors, and dopaminergic agents may serve as second-line treatments.
- Proper understanding facilitates recognition and effective treatment of PLC.
Conclusions:
- PLC is a distinct disorder of affect, manageable with appropriate pharmacological interventions.
- SSRIs offer effective first-line treatment for pathological laughing and crying.
- Further research into second-line treatments can benefit patients unresponsive to SSRIs.
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