Real Story:

After a long journey, she found an answer

Living with Multiple Sclerosis (MS) isn't easy—especially when you're raising two kids and studying toward a degree in social work. That's exactly what Karen was facing in 1995.

But she couldn't have anticipated the sudden, frequent, uncontrollable episodes of exaggerated crying and laughing that impacted her life. Karen was committed to finding an answer. Her journey toward a PBA diagnosis and treatment was a long one, but she never gave up.

Karen, Patient with Multiple Sclerosis and PBA, taking NUEDEXTA

Karen, Patient with Multiple Sclerosis and PBA, taking NUEDEXTA

Karen at a desk
Patient with Multiple Sclerosis and PBA, taking NUEDEXTA

“NUEDEXTA really has a significant impact. I feel better not having to worry as much about having an unpredictable episode in public.”

Living with MS

Through the years, while working, studying, raising her children, and managing her MS symptoms, Karen also had to cope with those uncontrollable crying and laughing episodes. “I would hide when I used to have a crying or laughing episode in front of my family or coworkers—I would go to the bathroom and wait it out,” Karen says. “I was very, very embarrassed!”


Discovering PBA

Finally, Karen found a name for the symptoms in an MS forum: Pseudobulbar Affect, also known as PBA—sudden, frequent, uncontrollable episodes of crying and/or laughing that are exaggerated and/or don’t match how the person feels. And in 2009, she heard about a clinical trial for a drug being studied for the treatment of PBA.

“I wanted to feel comfortable and to stop worrying about the crying and laughing episodes. I had to do something,” says Karen.

"I don’t want to go back to worrying so often about suddenly having a PBA episode. I'm grateful to be taking NUEDEXTA as my treatment for PBA.”

- Karen
Photo of Karen sitting outside

Seeing results with NUEDEXTA

The treatment in that trial became NUEDEXTA. Karen’s been taking NUEDEXTA since it became available for prescription in 2010 to reduce her PBA episodes, under her doctor’s supervision. Reducing her PBA episodes has allowed her to focus on other aspects of her life.

Karen is a real patient and has been compensated.

More stories

Photo of Carol

After an accident that caused a Traumatic Brain Injury, Carol began to cry uncontrollably without feeling sad. She was on a mission to find out why. Her PBA diagnosis was the key.

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.

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 (