Called pseudobulbar affect, the condition results in episodes of uncontrollable laughing or crying that may be inappropriate or not related to the situation. The condition can also occur with other neurological disorders such as amyotrophic lateral sclerosis (ALS), Alzheimer's disease, stroke, and brain injury.

For the study, 150 people with MS and pseudobulbar affect received either the drug AVP-923, which is a combination of the drugs dextromethorphan hydrobromide and quinidine sulfate, or a placebo for 12 weeks. The study participants kept a diary tracking the number of laughing/crying episodes they experienced each day, as well as any side effects, and were assessed at four clinic visits.

Of those taking the drug, 84 percent reported improvement in the condition, compared to 49 percent of those on placebo. Those taking the drug had 46 percent fewer emotional episodes during the study than those who received the placebo. They also reported overall improvement in the condition and improvement in their quality of life, quality of relationships, and amount of pain they experienced. Those taking the drug reported the side effect of dizziness more often than those taking the placebo did.

"This is the first drug designed specifically for this condition," said neurologist Hillel Panitch, MD, of the University of Vermont College of Medicine in Burlington, VT. "The only treatment now is antidepressants, which can have unpleasant side effects."

Panitch said the treatment showed improvements as early as the first week of treatment.

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Contact: Marilee Reu
mreu@aan.com
American Academy of Neurology
14-Apr-2005