Dextromethorphan/Quinidine for Pseudobulbar Affect Following Stroke: Safety and Effectiveness in the PRISM II Trial

Publication date: Available online 30 June 2018Source: PM&RAuthor(s): Richard D. Zorowitz, David N. Alexander, Andrea E. Formella, Fred Ledon, Charles Davis, Joao SiffertAbstractBackgroundDextromethorphan (DM)/quinidine (Q) was approved for pseudobulbar affect (PBA) treatment based upon efficacy and safety trials in patients with PBA secondary to amyotrophic lateral sclerosis or multiple sclerosis. The PRISM II trial evaluated DM/Q as PBA treatment in patients with stroke, dementia or traumatic brain injury.ObjectiveTo report results from the stroke cohort of PRISM II, including the Stroke Impact Scale (SIS).DesignOpen-label trial evaluating twice daily DM/Q over 90 daysStudy participantsAdults (n=113) with a clinical diagnosis of PBA secondary to stroke; stable psychiatric medications were allowed.MethodsPRISM II was an open-label, 12-week trial enrolling adults with PBA secondary to dementia, stroke (reported here), or TBI. All study participants received DM/Q 20/10 mg twice daily. Study visits occurred at baseline and at day 30 and day 90.Setting150 US centers.Main Outcome MeasurementsPrimary efficacy measure was change from baseline to day 90 in Center for Neurologic Study-Lability Scale (CNS-LS) scores. Secondary outcomes included PBA episodes (estimated over 7 days), Clinical and Patient/Caregiver Global Impression of Change (CGI-C and PGI-C), Quality of Life-Visual Analog Scale (QOL-VAS), SIS, Patient Health Questionnaire (PHQ-9), and Mini-Mental State Examination (MMS...
Source: PMandR - Category: Rehabilitation Source Type: research

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We have a total of 42 ICU beds in our community hospital. Acuity is high as we have a large catchment area and we serve as a referral site for surrounding hospitals. Trauma center and comprehensive stroke center. Trying to see how we could make things better. Currently we have 2 intensivists and 1 NP/PA on days. Open ICU and we see everyone on the vent and on vasoactive agents plus others if we are asked to help. We do multidis rounds on every patient in the unit, regardless of whether we... How is your ICU staffed?
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Critical Care Source Type: forums
Publication date: Available online 17 January 2020Source: The Lancet NeurologyAuthor(s): Frank Jessen, Rebecca E Amariglio, Rachel F Buckley, Wiesje M van der Flier, Ying Han, José Luis Molinuevo, Laura Rabin, Dorene M Rentz, Octavio Rodriguez-Gomez, Andrew J Saykin, Sietske A M Sikkes, Colette M Smart, Steffen Wolfsgruber, Michael WagnerSummaryA growing awareness about brain health and Alzheimer's disease in the general population is leading to an increasing number of cognitively unimpaired individuals, who are concerned that they have reduced cognitive function, to approach the medical system for help. The term su...
Source: The Lancet Neurology - Category: Neurology Source Type: research
ConclusionIt is envisaged that the current review will add value to more scientific research on M. flabellifolius and enhance/promote the increased interest in the sustainable commercialization of M. flabellifolius herbal tea as well as lead to the validation of unverified ethnobotanical claims.Graphical abstract
Source: Journal of Ethnopharmacology - Category: Drugs & Pharmacology Source Type: research
We describe below the design of dal-GenE, a precision medicine, placebo-controlled clinical outcome trial of dalcetrapib in patients with a recent acute myocardial infarction with the unique feature of selecting only those with the AA genotype at rs1967309 in the ADCY9 gene.
Source: American Heart Journal - Category: Cardiology Source Type: research
ConclusionThese results support the theory that underlying neurometabolite levels may be unique in different pain conditions and therefore representative of biomarkers for specific pain conditions.
Source: NeuroImage - Category: Neuroscience Source Type: research
(CNN) — Adults in the United States who binge drink are consuming even more alcohol per binging episode, according to a new study published Thursday by the US Centers for Disease Control and Prevention. Researchers analyzed data from the Behavioral Risk Factor Surveillance System over a six-year period and discovered that the annual number of binge drinks among adults who reported excessive drinking jumped on average from 472 in 2011 to 529 in 2017. That’s a 12% increase. In 2017, the number of binge drinks per year among adult binge drinkers ranged from 320 per year in Massachusetts to 1,219 in Wyoming. The nu...
Source: WBZ-TV - Breaking News, Weather and Sports for Boston, Worcester and New Hampshire - Category: Consumer Health News Authors: Tags: Boston News Health Syndicated CBSN Boston Binge Drinking CNN Massachusetts News Source Type: news
The robo-legs are being tested by 20 people with MS as part of a study at Kent and Canterbury Hospital. One MS patient to benefit from the trial is Richard Aske-Haley.
Source: the Mail online | Health - Category: Consumer Health News Source Type: news
Has anyone heard of this? I have a patient who just presented with weight loss and headache- found to have CA lung (most likely, biopsy pending) and a cerebellar lesion. He has always been completely bald but over the past few months, his hair have grown back and now has a full head of hair!! Im guessing its some kind of paraneoplastic phenomenon, but I couldn't find any info?
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Dermatology Source Type: forums
Young and middle-aged adults who vape and smoke are more likely to have had a stroke than those who use only one of these types of nicotine product, or none at all, a study suggests.Reuters Health Information
Source: Medscape Medical News Headlines - Category: Consumer Health News Tags: Public Health & Prevention News Source Type: news
We all know people who are well-educated but don’t know nuttin’. And we all know people with little formal education who are bright, brainy, maybe even brilliant. Obviously it’s not just what we learn in school that makes us smart. It’s how we live life.   If you wish to become smarter, you don’t need to go back to school (though that’s certainly an option). But you do need to develop the ability to reflect, reframe and rejoice. What’s so special about these 3 R’s? What happened to reading, writing and arithmetic? Of course, it’s important to know those basic ...
Source: World of Psychology - Category: Psychiatry & Psychology Authors: Tags: Motivation and Inspiration Self-Help Emotional Intelligence Source Type: blogs
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