PBA is the acronym used for PseudoBulbar Affect. It’s a neurological condition causing sudden, frequent episodes of uncontrollable laughing and crying. It can be caused by a stroke, Alzheimer’s, dementia, TBI or traumatic brain injury, Multiple Sclerosis or MS, Parkinson’s Disease, Other neurological conditions and even unknown causes.
During an episode, the patient may suddenly, without warning, begin to laugh or cry without reason. It doesn’t necessarily have anything to do with the current situation at hand and will seem out of character for the person or the situation. It is distinct from other emotional disturbances in that it happens very suddenly without rhyme nor reason.
It’s often very unsettling to the patients as well as to those around them. It may be confusing to try and understand why they have the episode and they may be even more upset about the event as it won’t even begin to match the situation at hand.
Doctors today can prescribe a medication for PBA called nuedexta®. It’s not completely understood how the drug works although doctors do know that it acts on the brain to change the chemistry to alter the emotions. It’s been approved by the FDA to treat PBA.
Other things that doctors work with the patient on is helping them to understand the condition and helping those around them to understand it. By contributing to the education of the patient and those around them it’s hoped that they will have more options and treatments available in the future.
The medication Neudexta classification belongs to a category that works on the central nervous system. It is made up of dextromethorphan (20 mg) and of quinidine (10 mg) AKS dextromethorphan hydrobromide USP and quinidine sulfate USP. It is not a controlled substance per the Controlled Substance Act or CSA.
Although it’s not considered a controlled substance, it’s one of the drugs still only available as a prescription. The FDA approved the drug for effects of PBA. It helps to alleviate the uncontrolled outbursts of crying and laughing. Doctors may also prescribe the drug other reasons that aren’t typically listed for the medication. It is considered a Class I Antiarrhythmic agent quinidine.
Although Nuedexta is used to treat an emotional condition, it’s not considered an anti-depressant nor is it used to treat depression. It doesn’t work on other emotional conditions only on PBA per studies that have been conducted for the last several years.
The most common side effects with Neudexta include stomach pain, diarrhea, excessive gas, dizziness, cough, swelling of hands and ankles or feet, vomiting and urinary tract infections.
Many patients state that it feels as if they have the flu. Liver tests may also have abnormal results. If the side effects are severe, it’s important to contact your doctor right away and follow their guidelines.
Some patients have been found to be allergic to some of the components in the product. Any side effects that aren’t on the list of effects should be reported to your doctor and the pharmacist immediately. Known interactions occur between oral Nuedexta and certain antiarrhythmics.
Typical dosing treatment protocols involve an oral taking of one capsule daily. After one week a patient’s dosage may increase up to two capsules daily taking one capsule every 12 hours.
While Nuedexta isn’t a controlled substance, doctors have been cautioned to carefully monitor patients who are on the prescription for any ill side effects. Some patients are more sensitive to the medications that make up Nuedexta than others.
Neudexta may cause hepatic as well as renal impairment, so close monitoring is required to ensure that patients are stable on the medication.xta may cause hepatic impairment as well as renal impairment so close monitoring is required to ensure that patients are stable on the medication.
PseudoBulbar Affect or PBA, is a frequent and uncontrollable fit of crying or laughing that happens suddenly without warning even if the situation doesn’t warrant the emotion. At present, there are approximately 2 million in the United States suffering from PBA.
Focus On What You Can Control
According to doctors, there are some strategies that patients are encouraged to adopt to make it easier to cope with PseudoBulbar Affect or PBA. Here are some of the strategies that patients are encouraged to use to help during the episodes.
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Be open and honest in discussing your condition with others. Tell them how you may suddenly begin to laugh or cry unexpectedly and that it doesn’t necessarily have anything to do with the situation at hand. It has to do with a neurological disorder with which you’re struggling.
Ask Your Doctor About Nuedexta
Nuedexta is an FDA approved medication that treats PBA. Always take it exactly as your doctor prescribes. He or she may want to do a few follow-ups to help adjust your medication as required.
In many cases, PBA improves on its own after a short period. Before you take the drug, discuss other medications that you may be taking with your doctor.
Know that if you’re on MAOIs or quinidine or related drugs that they may have an interaction with medication and cause some serious side effects. You shouldn’t take it if you’ve taken any MAOIs within the previous two weeks of consuming the medicine.
If you’ve had an allergic reaction to quinidine or related drugs or to dextromethorphan you shouldn’t take Nuedexta. Discuss any herbal supplements or vitamins that you’re taking with your doctor as well.
Don’t take this medicine if you’ve had heart disease or if you have a family history of heart disease. Your doctor may run some heart tests before prescribing the medication for your PBA.
Don’t take the drug if you have myasthenia gravis.
Call Your Doctor Immediately If Any Of The Following Occur As These May Be Signs Of An Allergic Reaction
Quinidine, which is an ingredient in the medicine, has been known to cause hepatitis.
Common Side Effects Of The Medication
The most common side effects to be aware of are diarrhea, cough, dizziness, vomiting, swelling of the feet and ankles, weakness and more. Be sure to call your doctor immediately if you’re unsure of any possible side effect. Talking to your physician will rule out the possibility of an allergic or potentially fatal reaction.
Your cost for a presriction can vary depending on insurance coverage and where you purchased the drug. According to a price guide from drugs.com, a 60 capsule count could cost $809 dollars using a discount card. Other locations offer the same supply at just under that price when you purchase the medicine with a coupon. The average retail price without any discounts or coupons comes in at just under $900 dollars.
If you can’t afford your co-pay or your medicine, call Nuedexta and discuss the options for your particular insurance. There are many options available that they can go over with you.
Many insurances will cover the cost. If you call Nuedexta, they can calculate what your exact payment should be and help you to find the right pharmacy for your specific needs.
Let your doctor know if you’re unable to afford any of your medications. He or she may also have other options available to assist you with your particular situation. Assistance programs may also be available.
Sometimes doctors will also have a limited supply of sample products that they can give to you to help partially defray the drug’s price and other medications. He or she may also be able to prescribe an alternative medicine.
Never skip medications or adjust dosages to “afford” your medications. Call the doctor and ask your pharmacist if they have any other options. Call the drug company if the physician or the pharmacist can’t assist you in affording your medication.