Deudextromethorphan/quinidine

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Deudextromethorphan/quinidine is a combination medication used in the treatment of Pseudobulbar Affect (PBA). This condition is characterized by uncontrollable, inappropriate laughing or crying, often seen in people with certain neurological conditions or injuries. The medication combines two active ingredients: deudextromethorphan and quinidine.

Composition[edit | edit source]

The medication is composed of two active ingredients: Deudextromethorphan and Quinidine. Deudextromethorphan is a NMDA receptor antagonist and sigma-1 receptor agonist, and it is the active ingredient responsible for the therapeutic effect of the medication. Quinidine, on the other hand, is a class I antiarrhythmic agent that serves to increase the bioavailability of deudextromethorphan through inhibition of the CYP2D6 enzyme.

Mechanism of Action[edit | edit source]

The exact mechanism of action of deudextromethorphan/quinidine in the treatment of PBA is not fully understood. However, it is believed that deudextromethorphan's antagonism of NMDA receptors and agonism of sigma-1 receptors in the brain play a key role. Quinidine increases the concentration of deudextromethorphan by inhibiting its metabolism by the CYP2D6 enzyme.

Indications[edit | edit source]

Deudextromethorphan/quinidine is indicated for the treatment of PBA. It is not intended for other types of emotional lability that can occur in individuals with neurological conditions or injuries.

Side Effects[edit | edit source]

Common side effects of deudextromethorphan/quinidine include dizziness, diarrhea, cough, vomiting, asthenia, peripheral edema, urinary tract infections, influenza, increased gamma-glutamyltransferase, and flatulence. Serious side effects may include thrombocytopenia and hepatitis.

Contraindications[edit | edit source]

Deudextromethorphan/quinidine is contraindicated in individuals with a history of quinidine, quinine, or mefloquine-induced thrombocytopenia, hepatitis, bone marrow depression, or lupus-like syndrome. It is also contraindicated in individuals who are hypersensitive to dextromethorphan.

Interactions[edit | edit source]

Deudextromethorphan/quinidine can interact with a number of other medications, including monoamine oxidase inhibitors (MAOIs), quinidine, quinine, mefloquine, SSRIs, and tricyclic antidepressants.

See Also[edit | edit source]

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Contributors: Prab R. Tumpati, MD