What is PBA?

If you have a neurologic condition such as Stroke, Alzheimer’s Disease and Dementia, ALS (Lou Gehrig’s Disease), Multiple Sclerosis, or Parkinson’s Disease or have had a Traumatic Brain Injury,* it's important to know about PBA (PseudoBulbar Affect).

Although often misunderstood as just another effect of the underlying neurologic condition or brain injury, PBA is a separate and treatable secondary neurologic condition that causes sudden, frequent, uncontrollable episodes of crying and/or laughing that are exaggerated and/or don’t match how you feel.

A post-traumatic brain injury patient living with PBA experiences a crying episode

A post-traumatic brain injury patient living with PBA experiences a crying episode

Why treat PBA?

We express our emotions to connect with those around us. But your crying and/or laughing during a PBA episode might not match how you feel at all, or might be exaggerated. And because PBA episodes are unpredictable and can happen at inappropriate times, including social situations, they can leave you feeling misunderstood and frustrated.

Reducing the number of PBA episodes you experience could help ensure that your crying and/or laughing matches the emotions you feel. If you think you could have PBA, now’s the time to talk to your doctor and seek treatment.

NUEDEXTA is the only treatment approved by the FDA to treat PBA.

Recognizing PBA

Watch for sudden, frequent, uncontrollable episodes of crying and/or laughing that are:

UNPREDICTABLE

PBA episodes can happen at any time. These crying and/or laughing episodes might or might not seem to be triggered by what’s happening at the moment.

EXAGGERATED

Crying and/or laughing during a PBA episode may be more intense or last longer than expected. For example, a person may cry excessively or for a long time after seeing a touching movie or laugh at a joke long after others have stopped.

MISMATCHED

PBA episodes might be inappropriate: they might not fit the situation or how the person is feeling. For example, a person might laugh at a funeral or cry when a friend shares good news.

Take the PBA Quiz

If you think you or someone you love might have PBA, take the PBA Quiz.

A post-stroke patient living with PBA and taking NUEDEXTA gets support from her caregiver during a crying episode in public
A post-stroke patient living with PBA and taking NUEDEXTA gets support from her caregiver during a crying episode in public

I told my neurologist about my extreme episodes of laughing and crying. PBA was the first thing she mentioned.

Post-Stroke patient living with PBA, taking NUEDEXTA

Conditions that can cause PBA

PBA can affect both men and women of any age. PBA is thought to affect about 2 million people in the US who suffer from common neurologic conditions or Traumatic Brain Injury.

Stroke

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A post-stroke patient living with PBA and taking NUEDEXTA embraces his wife, who is his caregiver

Because people recovering from a Stroke are often concerned with regaining lost function—and preventing another Stroke—it may be easy to overlook sudden, frequent, uncontrollable crying and/or laughing symptoms that don’t match how they feel or mistake the symptoms for depression.

For about a quarter of a million people in the US who have suffered a Stroke, these laughing and crying episodes may be PBA.

According to a survey of 500 Stroke patients (or their caregivers), 4.3% may have PBA. Based on this data, nearly 250,000 Stroke patients in the United States may have PBA.

American Stroke Association and Work SS, Colamonico JA, Bradley WG, Kaye RE. Pseudobulbar affect: an under-recognized and under-treated neurological disorder. Adv Ther. 2011;28:586-601.

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Traumatic Brain Injury (TBI)

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A post-traumatic brain injury patient living with PBA and taking NUEDEXTA has a laughing episode while at lunch with a friend

Traumatic Brain Injury (TBI) affects everyone differently. Some experience PBA symptoms of frequent, uncontrollable crying and/or laughing very soon after their injury. While for others, these symptoms may not be recognized until some months after their TBI, during the recovery process. Some never experience PBA at all.

According to studies, 800,000 people in the US, or about 15% of those who have suffered a Traumatic Brain Injury, may have PBA.

According to a survey of 326 TBI patients (or their caregivers), 15% may have PBA. Based on this data, 800,000 TBI patients in the United States may have PBA.

Centers for Disease Control (CDC) and National Center for Injury Prevention and Control (NCIPC), and Work SS, Colamonico JA, Bradley WG, Kaye RE. Pseudobulbar affect: an under-recognized and under-treated neurological disorder. Adv Ther. 2011;28:586-601.

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Alzheimer's Disease and Dementia

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An Alzheimer's patient living with PBA and taking NUEDEXTA talks in a coffee shop with his daughter, who is his caregiver

Alzheimer’s Disease and other Dementias can make PBA especially hard to spot, since sudden episodes of crying and/or laughing can be mistaken for Depression or other personality changes associated with Dementia. In addition, people in long-term care settings, like nursing homes, may not have the benefit of a single caretaker who can watch their behavior every day to look for patterns.

About 9.6% of people in the US with Alzheimer's Disease or Dementia may have PBA—over half a million people.

According to a survey of 499 Alzheimer's patients (or their caregivers), 9.6% may have PBA. Based on this data, 500,000 people living with Alzheimer's in the United States may also have PBA.

National Institute of Neurological Disorders and Stroke (NINDS), and Work SS, Colamonico JA, Bradley WG, Kaye RE. Pseudobulbar affect: an under-recognized and under-treated neurological disorder. Adv Ther. 2011;28:586-601.

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ALS (Lou Gehrig's Disease)

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A pocket watch sits on a table with other mementos

The symptoms of ALS (Lou Gehrig's Disease) can evolve and progress over time. PBA episodes can occur at any time during the course of ALS and may be mistaken for depression.

At least 27.5% of people with ALS in the US may have PBA.

According to a survey of 40 ALS patients (or their caregivers), 27.5% ALS patients in the US may have PBA.

The ALS Association and Work SS, Colamonico JA, Bradley WG, Kaye RE. Pseudobulbar affect: an under-recognized and under-treated neurological disorder. Adv Ther. 2011;28:586-601.

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Multiple Sclerosis (MS)

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A multiple sclerosis patient living with PBA and taking NUEDEXTA shares a moment with her daughter, who is her caregiver

Because MS may produce a wide variety of symptoms, and require different medications to treat them, people with MS who develop episodes of crying or laughing may not always know what's causing them. That's why it's important for patients to describe these episodes to their doctor—how long they last, how the patient feels while they're happening, and how they affect the patient.

In the US, 9.8% of people with MS (almost 40,000 people) may have PBA.

According to a survey of 504 MS patients (or their caregivers), 9.8% may have PBA. Based on this data, 40,000 MS patients in the United States may have PBA.

National MS Society and Work SS, Colamonico JA, Bradley WG, Kaye RE. Pseudobulbar affect: an under-recognized and under-treated neurological disorder. Adv Ther. 2011;28:586-601.

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Parkinson's Disease

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Beautiful bundles of tulips

Parkinson's Disease is a progressive condition known for its physical symptoms like muscle rigidity, slowed movement, tremors, and problems with posture and balance. Parkinson's Disease is often associated with reduced facial expression, so if you have sudden, frequent crying and/or laughing episodes that don't match how you feel inside, this may seem unexpected. While it’s important to make adjustments for physical symptoms, don’t forget to talk to a doctor if you or a loved one also have frequent, uncontrollable crying and/or laughing.

Over 35,000 people in the US with Parkinson's Disease (3.6%) may have PBA.

According to a survey of 449 Parkinson's patients (or their caregivers), 3.6% may have PBA. Based on this data, 35,000 Parkinson's patients in the United States may have PBA.

Parkinson's Disease Foundation and Work SS, Colamonico JA, Bradley WG, Kaye RE. Pseudobulbar affect: an under-recognized and under-treated neurological disorder. Adv Ther. 2011;28:586-601.

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PBA is different from Depression

PBA is not Depression. But because sudden, frequent, uncontrollable episodes of crying are a key feature of PBA, people sometimes mistake PBA for Depression. It's important to understand that the two are separate conditions. Some people can have both PBA and Depression. Both conditions are treatable and should be diagnosed by your doctor§ and managed separately.

Underlying Condition icon: brain
Underlying Condition
PBA

Occurs in people with neurologic conditions such as Stroke, Alzheimer’s and Dementia, ALS, MS, and Parkinson’s, or with brain injury*

Depression

May or may not have an underlying neurologic condition

Symptoms icon: eye
Symptoms
PBA

Sudden, frequent crying, laughing, or both

Depression

May include crying, loss of interest or pleasure, sad mood, appetite changes, or sleeping too much or too little

Duration icon: hourglass
Duration
PBA

Brief crying and/or laughing episodes last seconds to minutes

Depression

Depression symptoms may last weeks to months

Episode Control icon: knob
Episode Control
PBA

Crying and/or laughing episodes are uncontrollable

Depression

Crying, if present, may be voluntarily controlled or managed

Expression vs Feelings icon: heart
Expression vs Feelings
PBA

Crying and/or laughing are exaggerated or do not match how you feel

Depression

Outward expression matches feelings or intent

Accompanying Thoughts icon: head encircled by arrows
Accompanying Thoughts
PBA

Episodes may not be related to a happy or depressed mood

Depression

Crying, if present, matches mood

Proven to reduce PBA episodes

NUEDEXTA is the first and only treatment approved by the FDA to treat PBA.
 

See our results

PBA Quiz and Conversation Guide

Your quiz results and our PBA Conversation Guide will help you talk to your doctor about PBA and NUEDEXTA.

Take the PBA Quiz