New treatment helps control involuntary crying and laughing -- common in MS, ALS patients

Apr 13, 2010

Pseudobulbar affect (PBA) is a neurologic condition of involuntary, sudden and frequent episodes of laughing or crying and is quite common in patients with underlying neurologic diseases or injuries, especially those with multiple sclerosis (MS) and amyotrophic lateral sclerosis (ALS). Now, a new investigational treatment may help stop these involuntary outbursts. The research will be presented as part of the late-breaking science program at the American Academy of Neurology's 62nd Annual Meeting in Toronto, April 10 - 17, 2010.

"These outbursts of crying and laughter at inappropriate times can have a severe impact on patient and caregiver well-being, social functioning and quality of life," said study author Erik P. Pioro, MD, PhD, FRCPC, Director of the Section for ALS and Related Disorders at the Cleveland Clinic in Cleveland, Ohio, and a member of the American Academy of Neurology.

The study in patients diagnosed with PBA tested the effectiveness of a combination of two medications, dextromethorphan and low dose quinidine. The combination of the drugs is known as DMQ. After completing the blinded, placebo controlled phase of the study, participants could take part in a subsequent open label study where all of the participants would receive the DMQ drug combination for an additional 12 weeks. Of the 283 people completing the first phase, 253, or 89 percent, chose to take part in this subsequent open label study.

Participants were given daily doses of DMQ and were regularly given a test that measures the frequency and severity of their PBA. The study found that the average test score was significantly improved by 2.7 points from the start to the end of the open label study. Patients who were taking a placebo in the previous clinical trial and switched to DMQ demonstrated the most improvement.

"Our findings represent the first long-term results showing DMQ is effective in helping to control this debilitating condition afflicting patients with neurologic diseases or injuries," said Pioro. "Currently, there are no FDA approved treatments for PBA, which is problematic because currently used off-label treatments are often ineffective or may have unacceptable side-effects."

Pioro says these findings, along with additional clinical data, will serve as the basis for an application for FDA approval of DMQ as the first treatment for pseudobulbar affect.

Explore further: Built for speed: paranodal junction assembly in high performance nerves

add to favorites email to friend print save as pdf

Related Stories

AAN guideline evaluates treatments for muscle cramps

Feb 22, 2010

A new guideline from the American Academy of Neurology recommends that the drug quinine, although effective, should be avoided for treatment of routine muscle cramps due to uncommon but serious side effects. The guideline ...

Recommended for you

Device controls brain activity to maximize therapy

3 hours ago

Researchers at The Ohio State University Wexner Medical Center are trying to help patients who have suffered a stroke to improve arm movement by stimulating the brain using a device called a Transcranial ...

Scientists convert human skin cells into sensory neurons

4 hours ago

A team led by scientists from The Scripps Research Institute (TSRI) has found a simple method to convert human skin cells into the specialized neurons that detect pain, itch, touch and other bodily sensations. These neurons ...

Schizophrenic brains take indirect paths

9 hours ago

Analysis of the structural connectivity in the brains of 16 schizophrenia patients reveals several zones affected by the disease and their reduced network connectivity.

User comments : 1

Adjust slider to filter visible comments by rank

Display comments: newest first

Arkaleus
not rated yet Apr 13, 2010
These laughing and crying mechanisms are how the brain heals itself. There is more going on in the human mind than the nannies and caretakers need to worry themselves about. The very notion of drugging these stimulations away is medically unnecessary and ethically unjustifiable.

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.