Deans' stroke musings: PRISM II: An open-label study to assess effectiveness of dextromethorphan/quinidine for pseudobulbar affect in patients with dementia, stroke or traumatic brain injury

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Saturday, June 11, 2016

PRISM II: An open-label study to assess effectiveness of dextromethorphan/quinidine for pseudobulbar affect in patients with dementia, stroke or traumatic brain injury

If you have PBA then IF your doctor is any good at all s/he will be following this study closely and update your stroke protocols upon completion. But I can guarantee that unless YOU tell them about this nothing will happen. Your recovery is solely up to you, you can't depend on your doctors or therapists.
http://www.mdlinx.com/internal-medicine/medical-news-article/2016/06/10/dextromethorphan-quinidine-pseudobulbar-affect-dementia-brain/6712770/?news_id=881&newsdt=061116&subspec_id=488&utm_source=WeeklyNL&utm_medium=newsletter&utm_content=Weeks-Best-Article&utm_campaign=article-section&category=latest-weekly

In this open–label study, the physicians aim to assess the effectiveness of dextromethorphan/quinidine (DM/Q) for pseudobulbar affect (PBA) in patients with dementia, stroke or traumatic brain injury (TBI). This research found that DM/Q was an effective and well–tolerated treatment for PBA secondary to dementia, stroke, or TBI.

Methods

A total of 367 patients participated with PBA secondary to dementia, stroke, or TBI.
Participants received DM/Q 20/10 mg twice daily in this open-label, multicenter, 90-day trial.
The primary outcome was the Center for Neurologic Study-Lability Scale (CNS-LS), assessing change in PBA episode frequency and severity.
The authors compared the CNS-LS final visit score to baseline (primary analysis) and to the response in a previously conducted placebo-controlled trial with DM/Q in patients with ALS or MS.
Secondary outcomes included change in PBA episode count and Clinical Global Impression of Change with respect to PBA as rated by a clinician (CGI-C) and by the patient or caregiver (PGI-C).

Results

Mean (standard deviation [SD]) CNS-LS score improved significantly from 20.4 (4.4) at baseline to 12.8 (5.0) at Day 90/Final Visit (change, -7.7 [6.1]; P < .001, 95 % CI: -8.4, -7.0).
This magnitude of improvement was consistent with DM/Q improvement in the earlier phase-3, placebo-controlled trial (mean [95 % CI] change from baseline, -8.2 [-9.4, -7.0]) and numerically exceeds the improvement seen with placebo in that study (-5.7 [-6.8, -4.7]).
Reduction in PBA episode count was 72.3 % at Day 90/Final Visit compared with baseline (P < .001).
Scores on CGI-C and PGI-C showed that 76.6 and 72.4 % of participants, respectively, were “much” or ”very much” improved with respect to PBA.
IN this study the most frequently occurring adverse events (AEs) were diarrhea (5.4 %), headache (4.1 %), urinary tract infection (2.7 %), and dizziness (2.5 %); 9.8 % had AEs that led to discontinuation.
Serious AEs were reported in 6.3 %; however, none were considered treatment related.

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