If you have a motor neuron condition that means you laugh or cry uncontrollably for absolutely no reason you may worry that you are one of the only ones who suffer this or suffer unnecessarily. However, there has been treatment available for quite some time, and this surprisingly understudied disease is actually more prevalent than many realize.
In 2010 the FDA approved Avanir Pharmaceuticals to produce dextromethorphan and quinidine (DEX troe me THOR fan and KWIN i deen) sulfate capsules under the brand name of Nuedexta for the treatment of the Pseudobulbar affect (PBA).
However, before you self-diagnose and start looking to find a Nuedexta generic version, you should be aware that at this stage there is no generic option for the particular mix of the medication created by Avanir Pharmaceuticals.
More so, because Dextromethorphan has actually been used for more than 50 years to treat coughs, you may find that similar medications are marketed as being a generic replacement for Nudexta, when in fact that are just cough mixture. Combining dextromethorphan with quinidine slows the rate it metabolizes in the body, which is part of the reason why it has been able to be studied with renewed interest in the last 10 years, and why it needs to be created in very specific measurements.
Do I Need Nuedexta?
As this is a medication that can, and should, only be prescribed by your medical professional then you should absolutely get a consultation before thinking about treatment. But, with that said, it has had very positive results in helping to treat people who have uncontrollably laughing or crying, as well as other conditions.
This doesn’t mean that you see a sad television commercial and start ugly crying, or you find that you laugh hysterically when someone tells you that they have just been fired – although laughing or crying at inappropriate situations may be a symptom of pseudobulbar affect, there is more to it that this. https://www.mayoclinic.org/diseases-conditions/pseudobulbar-affect/symptoms-causes/syc-20353737
Up until recently Pseudobulbar affect has been primarily treated with an antidepressant medication, but as anyone who has ever tried to get the right antidepressant to treat ALL of their issues, this has had mixed results. So, the ability to be treated with what was effectively a cough suppressant is quite remarkable, but apparently effective, nonetheless.
Unfortunately, pseudobulbar effect rarely seems to present alone, and most people are already suffering from other neurological conditions – and this can make the diagnoses more difficult as it may be treated as a symptom of a primary condition such as:
- Amyotrophic lateral sclerosis (ALS)
- Multiple sclerosis (MS)
- Traumatic brain injury
- Alzheimer’s disease
- Parkinson’s disease
Which Is Worse – The Disease Or The Treatment?
For many conditions sometimes the treatment is actually worse that the disease itself, more so if the condition isn’t actually life threatening.
Nuedexta should not be taken if you have any of these conditions:
- heart failure or heart rhythm conditions
- use mefloquine, quinidine, or quinine.
- have an allergic reaction to mefloquine, quinidine, or quinine
- have used aMAO inhibitor within two weeks
Although there are always risks with any medication, the more common side effects associated with Nuedexta are manageable. There may be stomach cramps, diarrhea, farting and dizziness, there are also other more serious side effects that occur less frequently but should still be taken in to consideration.
The idea of suddenly bursting out into laughter may seem like a moment of joy for people who do not suffer emotional incontinence, it rarely manifests in such a joyful manner – and it seems that outbursts of crying are unfortunately more common that hysterical laughter. The effects that this condition may have on people can be extreme. Because you can never be sure when you will have an outburst, you cannot control for it – which means that many people originated jobs are out of the question.
Worse, because it is a condition that usually manifests on top of another neurological condition, you are likely already dealing with one condition in the workplace and trying to add another on top can just be too much for you, or for your colleagues.
It really comes down to which is going to interfere with your life more, the chance of farting or getting dizzy, or the risk of bursting into tears when someone asks you if you’d like a coffee.
Pathological crying and laughing (PCL) is still being researched (see here) but current estimates suggest that up to half of the people who have a motor neuron disorder also suffer from pathological crying and laughing, pseudobulbar affect, emotional lability, or involuntary emotional expression disorder – all names for the condition which are used interchangeably.
How Often Do I have To Take Nuedexta?
At this stage there is no commonly used off-label use for Nuedexta, so the dosages for treating PCL / PBA are one capsule daily for the first week, then one capsule every 12 hours for the length of the time that you are on the medication. Under the American healthcare system, it is usually funded by your insurance provider, included Medicare and Medicaid schemes – although you may also be able to get a co-pay savings card from the pharmaceutical company.
One of the stranger aspects of PBA is that it may suddenly disappear – so you should continue to consult with your medical practitioner about the condition on a regular basis. Your primary neurological condition may remain unchanged, but there is hope that this one could stop – unfortunately, as yet, no one knows why.