dextromethorphan/quinidine

Dextromethorphan and quinidine combination is prescribed for the treatment of pseudobulbar affect (PBA) or emotional incontinence, a rare condition. PBA is a neurological disorder characterized by involuntary and frequent episodes of crying or laughing.

Dextromethorphan is a medication that is commonly used to alleviate coughs caused by colds or the flu. However, it is not recommended for treating chronic coughs that are associated with smoking, asthma, or emphysema. Additionally, it should not be used when there is an excessive amount of mucus or phlegm present with the cough.

NUEDEXTA falls under the “Central Nervous System, Other” pharmacologic class in the USP-NF. It is not classified as an antipsychotic medication, psychotropic medication, or controlled substance.

Nuedexta is the sole FDA-approved treatment for PBA in individuals diagnosed with ALS and MS.

In certain patients, it has the potential to alter the rhythm of their heart and lead to fainting or severe adverse reactions. If you experience any indications of heart rhythm issues, such as rapid, forceful, or erratic heartbeats, please consult your physician immediately.

When taken in appropriate amounts, this medication effectively alleviates symptoms associated with colds and upper respiratory allergies. However, it is important to note that excessive consumption of this medicine, which includes chlorpheniramine maelate, can lead to severe consequences such as brain damage and even death. Additionally, it is worth mentioning that high doses of this medication may elevate heart rate, potentially resulting in heart attacks.

DXM is misused at high doses to attain feelings of euphoria and visual and auditory hallucinations. The quantity of DXM consumed varies based on the user’s body weight and the desired outcome.

If you are currently taking or have stopped taking a monoamine oxidase (MAO) inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) within the past 2 weeks, do not take dextromethorphan.

This medication is prescribed for the treatment of pseudobulbar affect, a mental/mood disorder that can be caused by various brain conditions including stroke, amyotrophic lateral sclerosis (ALS), and multiple sclerosis.

Quinidine is prescribed for the treatment of specific forms of irregular heart rhythms. It belongs to a group of drugs known as antiarrhythmic medications. Its mechanism of action involves enhancing the heart’s resistance to abnormal electrical patterns.

If you have high blood pressure, it’s important to consult with your healthcare provider or pharmacist before taking cough medications such as Mucinex (guaifenesin) and dextromethorphan (Delsym, Robitussin), as well as antihistamines like diphenhydramine (Benadryl). These medications are not known to raise blood pressure, but it’s best to seek professional advice before using them.

Based on the trial results, it was found that the combination of DM and MPH did not show superiority over MPH alone in treating children with ADHD. However, it is possible that DM could have adverse effects on ADHD symptoms when used in conjunction with MPH.

NUEDEXTA has been granted approval for the treatment of Pseudobulbar Affect (PBA), a medical condition characterized by uncontrollable and frequent episodes of crying and/or laughing in individuals with specific neurological conditions or brain injuries.

The individuals who were administered Nuedexta for a period of 90 days observed a positive change in their depression symptoms. However, it is important to note that the effects of Nuedexta on individuals with anxiety disorders have not been investigated. Additionally, the studies conducted on Nuedexta for TRD and bipolar disorder were limited in scope and did not include a comparison to placebo or other medications.

According to a single case report, Nuedexta was found to have antidepressant effects in a depressed patient with emotional lability.

Post hoc analysis of the 12-week Pivotal clinical trial showed that patients on NUEDEXTA experienced a significant reduction in PBA episodes compared to baseline. Over a period of 90 days, there was an 82% decrease in PBA episodes observed at Week 12. The treatment regimen involved patients receiving NUEDEXTA once daily in the first week and then transitioning to a dosage of once every 12 hours starting from Day 8.

Auvelity, a combination of dextromethorphan and bupropion, has recently received approval from the US FDA for the treatment of depression.

Nuedexta works by regulating the activity of neurotransmitters in the brain, which are responsible for controlling emotions. This helps to alleviate the symptoms of pseudobulbar affect.

You may experience diarrhea, dizziness, cough, vomiting, weakness, or swelling in the hands, ankles, or feet. In rare cases, you may also feel slightly drowsy. If any of these symptoms persist or worsen, please inform your doctor or pharmacist immediately.

NUEDEXTA falls under the “Central Nervous System, Other” pharmacologic class in the USP-NF. It is not classified as an antipsychotic medication, psychotropic medication, or controlled substance.

After a duration of 10 weeks, individuals who underwent Nuedexta treatment exhibited a reduction in symptoms associated with depression. Additionally, a separate clinical investigation focused on the effects of Nuedexta treatment on individuals diagnosed with bipolar disorder. Following a period of 90 days of treatment, participants reported a notable improvement in their symptoms of depression.

If you experience any difficulty breathing, weight gain, or swelling in your legs or ankles, it is important to inform your doctor immediately. This medication has been linked to a rare yet severe medical condition. Please consult with your doctor regarding any symptoms you should be vigilant about while taking this medication.

According to a single case report, Nuedexta was found to have antidepressant effects in a depressed patient with emotional lability.

Researchers analyzed the prescribing patterns and cost trends of Nuedexta, a medication commonly prescribed to patients with dementia and/or Parkinson’s disease who experience rapid and exaggerated mood changes.

Dextromethorphan can lead to a wide range of clinical effects, including mild agitation, psychosis, seizures, and coma, depending on the dosage and other substances taken alongside it. Altered mental status often prevents patients from providing a clear medical history.

Nuedexta (dextromethorphan / quinidine) typically begins to take effect after one week of use, resulting in a reduction in PBA episodes. However, it may take up to three months of consistent use to achieve the maximum benefits of this medication.

In addition to providing relief for other bulbar symptoms such as speech, facial muscle control, chewing, and swallowing, we have discovered that Nuedexta also offers overall relief.

The main indication of pseudobulbar affect (PBA) is the frequent occurrence of involuntary and uncontrollable outbursts of crying or laughing, which are either exaggerated or unrelated to one’s emotional state. Additionally, laughter often transitions into tears.

Dextromethorphan’s effectiveness for depression may be attributed to its impact on glutamate pathways, which are believed to be involved in the development of depression.

Medicare prescription drug plans usually place Nuedexta on Tier 5 of their formulary, which typically results in higher out-of-pocket costs for the medication. It is important to note that most plans consist of 5 tiers.

In 2010, the FDA granted approval for the use of dextromethorphan-quinidine in treating pseudobulbar affect. The pivotal trial for this approval involved a 12-week placebo-controlled randomized clinical trial with 326 middle-aged patients diagnosed with amyotrophic lateral sclerosis (ALS) or multiple sclerosis (MS) at the approved dose.

Quinidine (Q) was widely used in the 1970s and 1980s to prevent recurrent atrial fibrillation and reduce ventricular arrhythmias (VAs). However, it was mostly discontinued due to the discovery that Quinidine itself could lead to “quinidine syncope,” VAs, and sudden death.

Quinidine is currently only available in generic form, either as quinidine sulfate tablets or quinidine gluconate extended-release tablets. The previously available brand-names such as Cardioquin, Cin-Quin, and Quinidex are no longer on the market.

If you are currently taking or have stopped taking a monoamine oxidase (MAO) inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) within the past 2 weeks, do not take dextromethorphan.

Nuedexta is a medication that combines dextromethorphan and quinidine and is used to treat pseudobulbar affect (PBA).

To maintain dextromethorphan as an uncontrolled substance, an exemption was required as it is an optical isomer of the opiate levomethorphan (although it does not function as an opiate). Dextromethorphan is not subject to the Federal Analog Act due to the submission of a new drug application for it.

Quinidine can only be obtained with a prescription from your doctor. It is offered in the forms of tablets and extended-release tablets.

In 1952, the resolution of the two isomers of racemorphan with tartaric acid was published. Following this, dextromethorphan underwent successful testing in 1954 as part of research funded by the US Navy and CIA, aiming to find nonaddictive alternatives to codeine. Subsequently, in 1958, dextromethorphan was approved by the FDA as an over-the-counter antitussive.

In the mid-1990s, the availability of quinine over-the-counter and the marketing of prescription quinine products for leg cramps were banned by the Food and Drug Administration (FDA). However, in early 2007, the FDA allowed only Qualaquin to be prescribed as a quinine product.