ALSUntangled #71: Nuedexta.

Publication Title

Amyotroph Lateral Scler Frontotemporal Degener

Authors

Yuyao Sun
Michael Benatar
Javier Mascías Cadavid
Dave Ennist
Paul Wicks
Kim Staats
Morgan Beauchamp
Sartaj Jhooty
Gary Pattee
Andrew Brown
Tulio Bertorini
Paul Barkhaus
Mark Bromberg
Greg Carter, St Luke's Rehabilitation Institute, Spokane, WA, USAFollow
Richard Bedlack
Xiaoyan Li

Document Type

Article

Publication Date

7-26-2023

Keywords

washington; spokane

Abstract

Nuedexta is a combination of dextromethorphan hydrobromide and quinidine sulfate and was approved by the Food and Drug Administration (FDA) in 2010 to treat pseudobulbar affect (PBA). There have since been anecdotal case reports of bulbar function improvements after Nuedexta treatment. Here, we review the off-label use of Nuedexta for improving bulbar function in people with ALS. Nuedexta has plausible mechanisms for protecting brain stem motor neurons via its effects on S1R and glutamate excitotoxicity. Recent clinical trials support that Nuedexta can improve bulbar function in PALS, with or without PBA. Nuedexta causes mild to moderate side effects. Based on this information, we support considering Nuedexta treatment for bulbar dysfunction in ALS patients with or without PBA.

Clinical Institute

Neurosciences (Brain & Spine)

Specialty/Research Institute

Neurosciences

Specialty/Research Institute

Pharmacy