Pseudobulbar affect: prevalence and management

Therapeutics and Clinical Risk Management
Aiesha Ahmed, Zachary Simmons

Abstract

Pseudobulbar affect (PBA) may occur in association with a variety of neurological diseases, and so may be encountered in the setting of amyotrophic lateral sclerosis, extrapyramidal and cerebellar disorders, multiple sclerosis, traumatic brain injury, Alzheimer's disease, stroke, and brain tumors. The psychological consequences and the impact on social interactions may be substantial. Although it is most commonly misidentified as a mood disorder, particularly depression or a bipolar disorder, there are characteristic features that can be recognized clinically or assessed by validated scales, resulting in accurate identification of PBA, and thus permitting proper management and treatment. Mechanistically, PBA is a disinhibition syndrome in which pathways involving serotonin and glutamate are disrupted. This knowledge has permitted effective treatment for many years with antidepressants, particularly tricyclic antidepressants and selective serotonin reuptake inhibitors. A recent therapeutic breakthrough occurred with the approval by the Food and Drug Administration of a dextromethorphan/quinidine combination as being safe and effective for treatment of PBA. Side effect profiles and contraindications differ for the various treatme...Continue Reading

Citations

Jan 31, 2016·Pharmacology & Therapeutics·Linda NguyenRae R Matsumoto
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Dec 20, 2015·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Geying WangLingjing Jin
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Nov 4, 2015·International Journal of Geriatric Psychiatry·Kevin FoleyCharles Yonan
Dec 28, 2018·Neurology. Clinical Practice·Kathryn C FitzgeraldRuth Ann Marrie
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