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Thursday, November 4, 2010

First Treatment for Involuntary Crying and Laughing after Brain Injury

Posted by Prahallad Panda on 8:24 PM Comments

Emotional outbursts are seen among some patient recovering from brain injury either from trauma, stroke or neurological damage from some diseases like multiple sclerosis. Those may include involuntary crying laughing posing social inconvenience or embarrassment. That may result in social out cast. It is known as emotional incontinence or Pseudobulbar affect.

A drug treatment has been approved for the first time for this disease by US FDA. The combination pill include dextromethorphan and quinidine.
As reported in Medscape Medical News, results at 12 weeks showed that dextromethorphan 30 mg/quinidine 10 mg and dextromethorphan 20 mg/quinidine 10 mg significantly decreased the PBA episode daily rate by 46.9% and 49.0%, respectively, relative to placebo (P  .0001 for both comparisons).
Adverse events most commonly reported with use of dextromethorphan/quinidine in clinical trials include diarrhea (13%), dizziness (10%), cough (5%), vomiting (5%), asthenia (5%), and peripheral edema (5%); urinary tract infection, influenza, increased gamma-glutamyltransferase levels, and flatulence. Precautions should be taken to reduce the risk for falls resulting from dizziness, particularly in patients with motor impairment affecting gait or a history of falls.
The FDA warns that dextromethorphan/quinidine is linked to a risk for severe and potentially fatal immune-related thrombocytopenia that can be preceded by nonspecific symptoms such as light-headedness, chills, fever, nausea, and vomiting. Treatment should be permanently discontinued if thrombocytopenia develops.

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