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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