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InvisibleveggieM

Registered: 07/25/04
Posts: 17,538
Superpotent DXM Approved For Involuntary Laughing and Crying
    #13434035 - 11/04/10 01:30 PM (13 years, 6 months ago)

New Drug Approved For Emotional Incontinence
November 1, 2010 - NPR



Bernadetta Bailey was diagnosed with multiple sclerosis in 1981, when she was 20, and she has battled fatigue and muscle weakness ever since. She says her emotional problems began to appear in her 30s.

"There was no rhyme or reason" to her outbursts, she says. She could do something as simple as look at a light switch and burst into tears.

"It wasn't grief that overcame me but this emotion where I just started sobbing and sobbing and sobbing and couldn't quit," Bailey says, adding that she would also laugh inappropriately at funerals, or when someone got hurt.

The scientific name for the condition is pseudobulbar affect, or PBA. It's also known as emotional incontinence.

The Food and Drug Administration has approved the first drug that could help people like Bailey who suffer from PBA.

Alone And Emotional

PBA is caused when disease or injury creates a malfunction in the brain circuits involved in expressing emotion. It affects some people who have multiple sclerosis, ALS (Lou Gehrig's disease), Alzheimer's or Parkinson's. It also can strike people who have had a stroke, or a traumatic brain injury — including the sort that has become common among troops in Iraq and Afghanistan.

Bailey says whatever the cause, the outbursts are disruptive and embarrassing. "I just some days want to crawl in a hole," she says. "It makes other people uncomfortable because they think they should try and help me where there's nothing they can do."

So Bailey watched her kids compete in high school athletic events from inside her car. These days she spends a lot of time mountain biking or kayaking — by herself.

But Bailey says there was a brief period a couple of years ago when her PBA got much better. That's when her doctor enrolled her in a study of the drug that would become known as Nuedexta.

She remembers asking her doctor if he could tell her whether she'd be getting the drug or a placebo.

"He said, 'No, but you'll know it within a couple hours,' " Bailey says. "So I went in, they gave me a capsule, and an hour later, by the time I got home, I knew I was on the drug cause I wasn't crying all the time."

Discovered By Accident

Results submitted to the FDA showed that Nuedexta reduced episodes of PBA by about half.

That's quite a feat for a drug that was discovered by accident, says Erik Pioro, director of the section of ALS and related disorders at the Cleveland Clinic. Pioro also took part in the FDA trial of Nuedexta.

The active component of the product is dextromethorphan, which has been used for years in cough syrup, Pioro says. Researchers once hoped dextromethorphan could actually slow the progress of ALS. It didn't, he says. But some patients who got it noticed they were having fewer emotional outbursts.

By some estimates, about 2 million people in the U.S. suffer from PBA. But it's hard to get a precise figure because it's not something people like to talk about, Pioro says.

"Very often patients are too embarrassed to even bring up the possibility that they have something like that going on,” he says.

New Formulation

It has taken a dozen years to bring Nuedexta to market. One reason is that the product combines dextromethorphan with a drug called quinidine, which keeps the active ingredient in the bloodstream longer.

But quinidine can affect heart rhythms and has other side effects. So in 2006, the FDA asked Avanir, the small company developing Nuedexta, to study a formulation that used less quinidine.

By then, "we had very small amounts of cash," says Keith Katkin, Avanir's president and CEO. "But were able to find investors who were willing to take a bet and help us develop the first approved treatment for PBA."

Katkin says Nuedexta should begin reaching patients early in 2011 and that it's likely to cost $3,000 to $5,000 a year.

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Offlineidunno
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Registered: 03/02/10
Posts: 1,087
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Re: Superpotent DXM Approved For Involuntary Laughing and Crying [Re: veggie]
    #13434082 - 11/04/10 01:39 PM (13 years, 6 months ago)

DXM_ NOT just for ROBO tripping any more-  Used to be an RC back in the day cheaper than tussin


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The death of one man is a tragedy. The death of millions is a statistic..  Josef Stalin

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Invisiblesui
I love you.
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Registered: 08/20/04
Posts: 32,765
Loc: Cali, Contra Costa Co. Flag
Re: Superpotent DXM Approved For Involuntary Laughing and Crying [Re: veggie]
    #13434102 - 11/04/10 01:43 PM (13 years, 6 months ago)

3-5 k  a year? it might me better just to use the couch syrup depending on how often you would have to redose.


--------------------

"There is never a wrong note, bend it."
Jimi Hendrix


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InvisibleJesusGoneRogue
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Registered: 10/24/10
Posts: 9,495
Re: Superpotent DXM Approved For Involuntary Laughing and Crying [Re: sui]
    #13434205 - 11/04/10 02:04 PM (13 years, 6 months ago)

man dxm makes me itch.

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Offlineamenra
Rookie!
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Registered: 12/04/05
Posts: 1,048
Loc: In the Clouds
Last seen: 2 years, 7 months
Re: Superpotent DXM Approved For Involuntary Laughing and Crying [Re: JesusGoneRogue]
    #13434333 - 11/04/10 02:27 PM (13 years, 6 months ago)

Quote:

JesusGoneRogue said:
man dxm makes me itch.




ya by the end of the night.. I seem to always rub my nose raw


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Invisibletaterdb
Male


Registered: 07/07/10
Posts: 157
Loc: rocky mountain high
Re: Superpotent DXM Approved For Involuntary Laughing and Crying [Re: amenra]
    #13436741 - 11/04/10 11:25 PM (13 years, 6 months ago)

Dxm is weird stuff, i really dont like it except for its intended cough suppressant purpose. So its hard for me to imagine that taking it in large amounts on a daily basis would be helpful to anyone, i think id rather be all emotional.

But if they say it helps then whatever. I also wonder how strong it really is, can these people drive after taking their super potent dxm? Maybe its just like a double dose of the normal stuff, and not like when you drink a whole bottle of robo to trip, which is like 10 normal doses.

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Invisiblebadchad
Mad Scientist

Registered: 03/02/05
Posts: 13,379
Re: Superpotent DXM Approved For Involuntary Laughing and Crying [Re: taterdb]
    #13437434 - 11/05/10 04:41 AM (13 years, 6 months ago)

This is a 20 mg formulation of DXM.  Interesting that the press refers to it as "superpotent" after the addition of quinidine.


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...the whole experience is (and is as) a profound piece of knowledge.  It is an indellible experience; it is forever known.  I have known myself in a way I doubt I would have ever occurred except as it did.

Smith, P.  Bull. Menninger Clinic (1959) 23:20-27; p. 27.

...most subjects find the experience valuable, some find it frightening, and many say that is it uniquely lovely.

Osmond, H.  Annals, NY Acad Science (1957) 66:418-434; p.436

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InvisibleveggieM

Registered: 07/25/04
Posts: 17,538
Re: Superpotent DXM Approved For Involuntary Laughing and Crying [Re: badchad]
    #13437597 - 11/05/10 07:23 AM (13 years, 6 months ago)

I used the term superpotent to describe it. Nowhere in the article does it say or suggest patients were "taking it in large amounts". The addition of quinidine makes DXM more potent by keeping "the active ingredient in the bloodstream longer" which would require smaller dosages not larger. Yes the medication contains just 20mg DXM which is taken only once daily initially, being less than the dosage taken for coughs.

Which takes us back to sui's point that a patient without 3-5k could take OTC DXM. I would think that they could.

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