Overview
Diagnosis
Pseudobulbar affect (PBA) is usually diagnosed during a neurological evaluation. Specialists who can diagnose PBA include internists, neuropsychologists, neurologists, and psychiatrists.
PBA is often misdiagnosed as depression, bipolar disorder, generalized anxiety disorder, schizophrenia, personality disorders, or epilepsy. To help your healthcare professional determine if you have PBA, provide detailed information about your emotional outbursts, including their frequency, triggers, and intensity.
Treatment
The main goal of treatment for pseudobulbar affect (PBA) is to reduce the frequency and severity of emotional outbursts.
Medication options include:
Antidepressants, such as tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs). These medications can help reduce PBA episodes and are usually prescribed at lower doses than those used for depression.
Dextromethorphan hydrobromide and quinidine sulfate (Nuedexta), the only FDA-approved medication specifically for PBA. Studies in people with multiple sclerosis (MS) and amyotrophic lateral sclerosis (ALS) showed that this medication can reduce laughing and crying episodes by about half compared with a placebo.
Your healthcare professional will help you choose the most appropriate therapy, considering potential side effects and any other medical conditions or medications you may be taking.
Occupational therapy may also be recommended to help you develop strategies for completing daily tasks despite PBA symptoms.
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