Terms such as forced crying, involuntary crying, pathological emotionality, and emotional incontinence have also been used, although less frequently.. The Art of Autism is a 501c3 nonprofit. The serotonergic action of SSRIs and TCAs is thought to be significant in the treatment of PBA, as serotonin increases at the synapses in the corticolimbic and cerebellar pathways.3,16,17 SSRIs have a relatively narrow mechanism of action, directed toward enhancing serotonergic function, whereas TCAs alter a broader range of neurotransmitter functions.
It can happen in people with a brain injury or certain …
The cardinal feature of the disorder is a pathologically lowered threshold for exhibiting the behavioral response of laughter, crying, anger or all of the above. In depressive and bipolar disorders, crying, anger or laughter are typically a indicative of mood, whereas the pathological displays of crying which occur in PBA are often in contrast to the underlying mood, or greatly in excess of the mood or eliciting stimulus. Serotonin, presynaptic 5-HT3 receptors and synaptic plasticity in the developing cerebellum.
The combination of dextromethorphan 30 mg plus quinidine 30 mg (AVP-923 = DHQ 30/30) was compared with dextromethorphan monotherapy and quinidine monotherapy. Copyright © 1995-2020 Psych Central. PBA occurs … King RR, Reiss JP. Three double-blind, multicenter trials provided the efficacy data and basis for the FDA approval and use of DHQ in patients with PBA. Education of patients, families, and caregivers is an important component of the appropriate treatment of PBA.
Ann Neurol. If you do not want your question posted, please let us know. The symptoms of PBA can be severe, with persistent and unremitting episodes. However, in some other patients, the character of the emotional display can be incongruent with, and even contradictory to, the emotional valence of the provoking stimulus or may be incited by a stimulus with no clear valence. Miller A, Pratt H, Schiffer RB.
PBA is most commonly observed in people with neurologic injuries such as traumatic brain injury (TBI) and stroke, and neurologic diseases such as dementias including Alzheimer's disease, attention deficit/hyperactivity disorder (ADHD), multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS), PANDAS in children and adults, and Parkinson's disease (PD). The level of control that one has over the crying, anger or other emotional displays in PBA is minimal or nonexistent, whereas for those suffering from depression, the emotional expression (typically crying) can be modulated by the situation.
Research helps us better understand diseases and can lead to advances in diagnosis and treatment. N Engl J Med, 1985;312:1480-1482.29. Engelman W, Hammond FM, Malec JF.  The relationship between post-stroke depression and PBA is complicated, because the depressive syndrome also occurs with high frequency in stroke survivors. Pseudobulbar affect (PBA) is a type of affect lability characterized by sudden, frequent, and uncontrollable episodes of crying and/or laughing.
 The term pseudobulbar (pseudo- + bulbar) came from the idea that the symptoms seemed similar to those caused by a bulbar lesion (that is, a lesion in the medulla oblongata). Cummings JL, Arciniegas DB, Brooks BR, et al.
Since SSRIs’ mechanism of action is primarily directed to serotonergic neurotransmission, the side-effect profile may be less problematic than that of TCAs. Why autistic adults struggle with employment, 50 Positive traits of many with Aspergers. PBA occurs secondary to many neurological disease states.6 The most common diseases associated with PBA are Alzheimer’s disease (AD), ALS, multiple sclerosis (MS), Parkinson’s disease (PD), stroke, and traumatic brain injury (TBI).5,10 The exact cause of PBA is unknown, but it is thought to be related to nerve impulse disruption from the cerebellum to the limbic and paralimbic systems.10 Dysregulation and disinhibition in the frontal cortex are also thought to be part of the process underlying PBA. Schiffer RB, Herndon RM, Rudick RA.  In Chapter VI, "Special Expressions of Man: Suffering and Weeping", Darwin discusses cultural variations in the acceptability of weeping and the wide differences in individual responses to suffering. This variation ranges from poor metabolizer to ultra-rapid metabolizer, making pharmacokinetic and pharmacogenomic considerations an important factor when selecting treatment.36. Traditionally, antidepressants such as sertraline, fluoxetine, citalopram, nortriptyline and amitriptyline have been prescribed with some efficacy.
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