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.

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