Thursday, June 4, 2015

Dextromethorphan, Quinidine Effective for Pseudobulbar Affect Secondary to Dementia

This is PBA after dementia, what about after stroke? Whom is going to answer that question? ASA or NSA are you going to sponsor research to answer that f*ckingly simple question? Or are you going to continue to sit on your ass WAITING FOR SOMEONE ELSE TO SOLVE THE PROBLEM?
Dextromethorphan, Quinidine Effective for Pseudobulbar Affect Secondary to Dementia
 A fixed combination of dextromethorphan and quinidine has demonstrated efficacy in treating pseudobulbar affect (PBA) and depressive symptoms in patients with dementia, researchers reported here at the 168th Annual Meeting of the American Psychiatric Association (APA).
“The PRISM-2 is an open label study that enrolled patients with PBA secondary to dementia, stroke, or traumatic brain injury,” explained Andrew Cutler, MD, Florida Clinical Research Center, LLC, Sarasota, Florida.
The analysis focused on patients form PRISM-2 who had PBA secondary to dementia to determine if the medication had any impact on treating any depression that patients experienced.
“The way that this medication works suggests that it will affect mood,” said Dr. Cutler. “These were no patients who had significant clinical depression, but they had depressive symptoms.”
PBA symptoms were significantly enhanced from study entry to the 12-week mark, with a 67.7% decrease in PBA episodes and a mean change of -7.2 on the Center for Neurologic Study-Liability Scale (P< .001).
“By day 90, the PBA episodes were cut down to 3 a week,” said Dr. Cutler, noting patients had multiple PBA episodes daily at study entry. “There was tremendous improvement in episodes of PBA.”
The study also looked at depressive symptoms as measured by the Patient Health Questionnaire-9. They found an improvement on that scale that was statistically significant, with a change from 13.2 at study entry to 7.4 after 12 weeks (P< .001).
Of note, there was not a direct relationship between improvement in PBA symptoms and reduction in depressive symptoms.
The most common adverse events were headache, urinary tract infection, and diarrhoea.
The study was limited by the fact that it was not randomised; rather it was an open-label design.
Funding for this study was provided by Avanir Pharmaceuticals, Inc.
[Presentation title: Dextromethorphan Quinidine for Pseudobulbar Affect Secondary to Alzheimer’s Disease/Dementia: Effect on Mood Symptoms in PRISM-II Dementia Cohort. Abstract P8-085]

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