Table 1 Completed double-blind clinical trials of pharmacological interventions in PBA

From: Review of Dextromethorphan 20 mg/Quinidine 10 mg (NUEDEXTA®) for Pseudobulbar Affect

References N Syndrome studied Subjects’ primary diagnosis Treatment arms; study design Main efficacy measures
Schiffer et al. [12] 12 Pathological laughing and weeping MS Amitriptyline vs. placebo; crossover; 30 days of each treatment Clinical judgment; episode rate
Robinson et al. [6] 28 PLC Stroke Nortriptyline vs. placebo; parallel groups; 6 weeks PLACS [6]
Andersen et al. [13] 16 Pathological crying Stroke Citalopram vs. placebo; crossover; 3 weeks of each treatment Episode rate
Brown et al. [14] 20 Emotionalism Stroke Fluoxetine vs. placebo; parallel groups; 10 days Unvalidated severity scales; episode rate
Burns et al. [16] 28 Lability of mood; emotionalism; tearfulness Stroke Sertraline vs. placebo; parallel groups; 8 weeks Unvalidated severity scale; episode rate
Brooks et al. [26] 129 PBA ALS DM/Q 30/30 mg vs. DM 30 mg vs. Q 30 mg; parallel groups; 4 weeks CNS-LS [7]; episode rate
Murray et al. [17] 123 Emotionalism Stroke Sertraline vs. placebo; parallel groups; 26 weeks Self-assessed presence/absence of “tearfulness”
Choi-Kwon et al. [15] 106 Excessive or Inappropriate Crying Stroke Fluoxetine vs. placebo; parallel groups; 3 months Unvalidated severity VAS
Panitch et al. [28] 150 PBA MS DM/Q 30/30 mg vs. placebo; parallel groups; 12 weeks CNS-LS [8]; episode rate
Pioro et al. [27] 326 PBA ALS or MS DM/Q 30/10 mg and DM/Q 20/10 mg vs. placebo; parallel groups; 12 weeks CNS-LS [7, 8]; episode rate
  1. English-language reports published after 1979
  2. ALS amyotrophic lateral sclerosis, CNS-LS Center for Neurologic Study-Lability Scale, DM/Q dextromethorphan/quinidine, MS multiple sclerosis, PBA pseudobulbar affect, PLACS Pathological Laughter and Crying Scale, PLC pathological laughing and crying, VAS Visual Analog Scale