CPCP: Pseudobulbar Affect From Resident Drs. Morse and Segraves

Dr. Andrew Segraves DO

Dr. Andrew Segraves DO

Dr. Emily Morse DO

Dr. Emily Morse DO

This is a superb Clinical Problems in Consultation Psychiatry (CPCP0 on pseudobulbar affect put together by a couple of outstanding junior residents in our department, Dr. Emily Morse, DO and Dr. Andrew Segraves, DO.

Occasionally the psychiatry consultation service is called to help with this issue in patients who have suffered strokes or other brain injury or disease that leads to pathologic crying. Pathologic laughing also occurs but is much less common.

Dr. Robert G. Robinson, MD, the former chair of our department, has done a great deal of research in poststroke syndromes and is widely published and cited in the literature, including that included in this CPCP.

I’m not as familiar with the newer treatment, Neudexta. I think it’s important to remember that the quinidine with which dextromethorphan is combined could potentially lead to the “quinidine-like effects” on cardiac rhythm that medical students learn about, including possible prolongation of cardiac conduction (e.g., QTc interval).

There’s even a slide with an important reminder alluding to our consult service mascot, Nigella.

Slide2

In order to see the picture galleries of photos or powerpoint slides, click on one of the slides, which will open up the presentation to fill the screen. Use the arrow buttons to scroll left and right through the slides or up and down to view any annotations.

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Comments

  1. Dr. Emily Morse found this interesting educational video (presented by Avanir Pharmaceuticals, the maker of NueDexta) about pseudobulbar affect:

    https://www.pbafacts.com/

    And here is a counterbalancing blog post about NueDexta by Dr. Steve Balt, MD, Editor-in-Chief of the Carlat Psychiatry Report:

    http://thoughtbroadcast.com/2011/04/18/nuedexta-pipeline-in-a-pill-or-pipe-dream/

    Like

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