Efficacy of DM/Q Tested in Treating Involuntary Laughter/Crying in Dementia Patients

A total of 367 PBA patients were included in the trial
A total of 367 PBA patients were included in the trial

VANCOUVER, BC—Dextromethorphan/quinidine (DM/Q) is effective in treating pseudobulbar affect (PBA: involuntary laughing and crying) associated with dementia, stroke and traumatic brain injury (TBI), according to findings presented at the 68th AAN Annual Meeting.

“PRISM II is the first prospective, systematic study to evaluate DM/Q effectiveness (including safety and tolerability) for PBA secondary to dementia, stroke, or TBI,” wrote Joao Siffert, MD, chief medical officer at Avanir Pharmaceuticals in Aliso Viejo, CA, and coauthors, in a poster presentation.

“The observed PBA symptom reduction in this trial was consistent with that seen in well-controlled DM/Q phase 3 trials conducted with patients with ALS or MS,” the researchers reported.

The findings “demonstrate DM/Q effectiveness for PBA regardless of neurologic etiology,” they concluded. Improvements “appeared to be clinically meaningful.”

Inclusion criteria for the study included PBA diagnosis and a Center for Neurologic Study-Lability Score (CNS-LS) of ≥13, and a clinical diagnosis of stable or not-rapidly-changing dementia, stroke, or non-penetrating TBI. Depression, psychotic disorders, substance abuse and severe dementia were all exclusion criteria.

“All patients received DM/Q 20/10mg twice daily (once daily during Week 1),” the authors reported. A total of 298 patients were evaluable for DM/Q effectiveness and 271 completed the study through Day 90, at which point the mean CNS-LS score of the group reduced from baseline by -7.7 (standard deviation [SD] 6.1; P<0.001).

“Overall, PBA episodes were reduced by an estimated 57.5% at Day 30 and 72.3% at Day 90, compared with baseline” (P<0.001 for both), the researchers reported.

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