Real Story:

A survivor who kept pushing for answers

Robert had been a proud United States Army paratrooper. During a routine jump in 1991, he suffered multiple injuries including a Traumatic Brain Injury. Recovery became his full-time job. But the sudden, frequent, uncontrollable crying episodes that followed his injury were to remain undiagnosed for more than 25 years. Then, a commercial prompted him to talk to his doctor and he finally received a PBA diagnosis. Robert was treated with NUEDEXTA.

Robert, Patient with Traumatic Brain Injury and PBA, taking NUEDEXTA

Robert, Patient with Traumatic Brain Injury and PBA, taking NUEDEXTA

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

“Talk to your doctor. And keep talking.”

Frustrating episodes

"I took the medicine they prescribed for depression, but the uncontrollable crying episodes kept happening. It was really tough.” His relatives, friends, and acquaintances didn’t understand why he was experiencing episodes of uncontrollable crying.

Years later Robert still experienced several episodes a day. He learned to deal with them by running to the bathroom to hide, or pulling the car over to wait for the crying to pass.


Path to a diagnosis

Robert saw a commercial that stopped him in his tracks. "I understood what they were talking about.” That commercial explained PBA (Pseudobulbar Affect). “I was surprised! I couldn’t believe that I had finally heard the name for what could be causing my uncontrollable crying.”

"With NUEDEXTA, I don’t have to live in fear of having crying episodes so often."

- Robert
Photo of Robert inside

Robert researched and gathered information to bring to his doctor's appointment. While he was talking to his doctor, he had a PBA episode. His doctor saw that Robert had also suffered a Traumatic Brain Injury, one of the conditions that can cause PBA, and diagnosed him with PBA and prescribed treatment with NUEDEXTA.


Seeing results with NUEDEXTA

Now Robert has fewer crying episodes. He’s continuing treatment with NUEDEXTA, and he has advice for people who think their crying and laughing symptoms might be PBA.

“I tell everybody to be open and receptive—to talk it out as best you can. Advocate for your own well-being, in a way that you’re most comfortable. Explain the symptoms you are having and the impact it can have on your life,” says Robert. “You have to explain what you’re going through as best as you can, so your doctor can help you manage it.”

Robert 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 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 (