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Case 37 - “Everyone Is Just So Good to Me!”

Pseudobulbar Affect

Published online by Cambridge University Press:  31 October 2024

Matthew Gibfried  and
George T. Grossberg
Matthew Gibfried
Affiliation:
Saint Louis University School of Medicine, Missouri
George T. Grossberg
Affiliation:
Saint Louis University School of Medicine, Missouri
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Summary

Pseudobulbar affect is described as episodes of involuntary, unprovoked, and sudden episodes of crying or laughing that happen as a result of central nervous system pathology. Pseudobulbar affect can be easily overlooked or misdiagnosed as a primary mood disorder. Several classes of medications have been used to treat it with varying success. These include SSRIs, SNRIs, and tricyclic antidepressants. Dextromethorphan/quinidine (Nuedexta) was approved in 2010 for the treatment of pseudobulbar affect.

Keywords

pseudobulbar affectemotional dysregulation
Type
Chapter
Information
Clinical Case Studies in Long-Term Care Psychiatry
Navigating Common Mental Health Challenges in Geriatric Care
 , pp. 188 - 190
Publisher: Cambridge University Press
Print publication year: 2024

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References

References

Hakimi, M., & Maurer, C. W. (2019). Pseudobulbar affect in Parkinsonian disorders: A review. Journal of Movement Disorders, 12 (1), 14–21. https://doi.org/10.14802/jmd.18051CrossRefGoogle ScholarPubMed
Ahmed, A., & Simmons, Z. (2013). Pseudobulbar affect: Prevalence and management. Therapeutics and Clinical Risk Management, 9, 483–489.Google ScholarPubMed

Further Reading

Choi-Kwon, S., Han, S. W., Kwon, S. U., Kang, D. W., Choi, J. M., & Kim, J. S. (2006). Fluoxetine treatment in poststroke depression, emotional incontinence, and anger proneness: A double-blind, placebo-controlled study. Stroke, 37 (1), 156–161.CrossRefGoogle ScholarPubMed
Fitzgerald, K. C., Salter, A., Tyry, T., Fox, R. J., Cutter, G., & Marrie, R. A. (2018). Pseudobulbar affect: Prevalence and association with symptoms in multiple sclerosis. Neurology: Clinical Practice, 8 (6), 472–481. https://doi.org/10.1212/CPJ.0000000000000523Google ScholarPubMed
Fralick, M., Sacks, C. A., & Kesselheim, A. S. (2019). Assessment of use of combined dextromethorphan and quinidine in patients with dementia or Parkinson disease after US Food and Drug Administration approval for pseudobulbar affect. JAMA Internal Medicine, 179 (2). https://doi.org/10.1001/jamainternmed.2018.6112CrossRefGoogle ScholarPubMed
Miller, A., Pratt, H., & Schiffer, R. B. (2011). Pseudobulbar affect: The spectrum of clinical presentations, etiologies and treatments. Expert Review of Neurotherapeutics, 11 (7), 1077–1088. DOI: 10.1586/ern.11.68CrossRefGoogle ScholarPubMed
Pioro, E. P., Brooks, B. R., Cummings, J., Schiffer, R., Thisted, R. A., Wynn, D., Hepner, A., & Kaye, R. (2010). Dextromethorphan plus ultra-low-dose quinidine reduces pseudobulbar affect. Annals of Neurology, 68 (5), 693–702.CrossRefGoogle ScholarPubMed

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