Be Aware of Nuedexta's Off-Label Use
You may see patients admitted on dextromethorphan/quinidine (Nuedexta) to treat agitation or psychosis related to dementia.
Nuedexta is only approved for pseudobulbar affect...a condition with uncontrollable bouts of crying or laughing. But preliminary, short-term evidence suggests it might improve agitation in some Alzheimer's patients.
The dextromethorphan blocks NMDA and may act as an SNRI...while the quinidine "boosts" dextromethorphan levels by inhibiting CYP2D6.