Real Story:

A passion for life helped her find answers

Carol is an adventurous high school librarian from Pennsylvania, with a loving husband and two adult children. One day at work, she was organizing school memorabilia in the library’s vault. While moving a heavy shelf, it slipped and struck her head. That’s when it all started.

Carol remembers the injury, and that later she finished work and drove herself home. It wasn’t until the next day that Carol’s colleagues noticed that something just wasn’t right about the way she was acting and encouraged her to visit a doctor.

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Carol, Patient with Traumatic Brain Injury and PBA, taking NUEDEXTA. Click here to download the video transcript.

Photo of Carol
Patient with Traumatic Brain Injury and PBA, taking NUEDEXTA

“The crying episodes were horrible. Every medical practitioner said ‘you’ll get better, just give it time.’”

Misunderstood, frustrated

Over time, Carol was gripped by episodes of uncontrollable crying, even though she didn’t feel sad. Eventually, her unpredictable episodes began affecting her work and even the amount of time she was willing to spend with her family.

The doctors Carol saw assumed these episodes were just a part of her life after her accident. They thought her crying episodes were a symptom of depression and prescribed antidepressants. “I couldn’t even convey my symptoms to the doctors,” Carol says. “They would say, ‘It’s just emotional.’ But, I knew it was more than that. I knew something was seriously wrong.”


One diagnosis was the key

Carol continued to experience sudden, frequent, uncontrollable crying episodes for over a year. She sought answers by researching her symptoms, as any librarian would. She and her family consulted several healthcare professionals. Finally, a neurologist diagnosed her episodes as PBA (Pseudobulbar Affect) and prescribed NUEDEXTA.

"When I was diagnosed with PBA, I was so relieved there was name for it—it was a real thing that was affecting me,” Carol says.

"After the unpredictable crying episodes started, I found it hard to plan some of the activities I was used to—for fear of having an episode.”

- Carol
Photo of Carol outside
Seeing results with NUEDEXTA

“After treatment with NUEDEXTA, I could tell it was working because I was having fewer episodes,” says Carol. She continues to experience reduced PBA episodes by taking NUEDEXTA twice a day, as directed.

Carol is sharing her story to encourage other people to talk to their doctors. Her main advice for anyone diagnosed with PBA and prescribed NUEDEXTA is this: “When starting NUEDEXTA, I would tell others to give it time and be patient, because it’s worth it.”

Carol is a real patient and has been compensated.

More stories

Photo of Robert

Robert lived with uncontrollable crying symptoms for decades after sustaining a Traumatic Brain Injury in the military. Getting his PBA diagnosis was a major milestone.

Photo of Karen

While she was learning to live with Multiple Sclerosis, uncontrollable crying and laughing epsiodes impacted Karen's life. After years of misdiagnoses, she was correctly diagnosed with PBA and was prescribed NUEDEXTA.

Send Me PBA Conversation Cards

Prepare yourself and the people close to you to talk about the impact of PBA on your lives. Then, talk to your doctor.

Understand the treatment

Learn how to take NUEDEXTA and what to expect during treatment, and review important safety information.

NUEDEXTA® (dextromethorphan HBr and quinidine sulfate)


NUEDEXTA is approved for the treatment of Pseudobulbar Affect (PBA).

PBA is a medical condition that causes involuntary, sudden, and frequent episodes of crying and/or laughing in people living with certain neurologic conditions or brain injury. PBA episodes are typically exaggerated or don’t match how the person feels. PBA is distinct and different from other types of emotional changes caused by neurologic disease or injury.

NUEDEXTA is only available by prescription.


Before you take NUEDEXTA, tell your doctor:

  • If you are taking monoamine oxidase inhibitors (MAOIs), quinidine, or quinidine-related drugs. These can interact with NUEDEXTA causing serious side effects. MAOIs cannot be taken within 14 days before or after taking NUEDEXTA.
  • If you have previously had an allergic reaction to dextromethorphan, quinidine or quinidine-like drugs.
  • About all medicines, herbal supplements, and vitamins you take as NUEDEXTA and certain other medicines can interact causing side effects.
  • If you have had heart disease or have a family history of heart rhythm problems. NUEDEXTA may cause serious side effects, including changes in heart rhythm. If you have certain heart problems, NUEDEXTA may not be right for you. Your doctor may test your heart rhythm (heartbeats) before you start NUEDEXTA.
  • If you have myasthenia gravis.


While taking NUEDEXTA, call your doctor right away:

  • If you feel faint or lose consciousness.
  • If you experience lightheadedness, chills, fever, nausea, or vomiting as these may be signs of an allergic reaction to NUEDEXTA. Hepatitis has been seen in patients taking quinidine, an ingredient in NUEDEXTA.
  • If you have unexplained bleeding or bruising. Quinidine, an ingredient in NUEDEXTA, can cause a reduction in the number of platelets in your blood which can be severe and, if left untreated, can be fatal.
  • If you feel dizzy, since it may increase your risk of falling.
  • If you have muscle twitching, confusion, high blood pressure, fever, restlessness, sweating, or shivering, as these may be signs of a potential drug interaction called serotonin syndrome.

The most common side effects of NUEDEXTA include: diarrhea, dizziness, cough, vomiting, weakness, and swelling of feet and ankles. This is not a complete list of side effects. Tell your doctor about any side effect that bothers you or does not go away.

You are encouraged to report side effects of NUEDEXTA® (dextromethorphan HBr and quinidine sulfate). Please contact Otsuka America Pharmaceutical, Inc. at 1-800-438-9927 or FDA at 1-800-FDA-1088 (