The psychopharmacology of pseudobulbar affect

Handb Clin Neurol. 2019:165:243-251. doi: 10.1016/B978-0-444-64012-3.00014-9.


Pseudobulbar affect (PBA) is characterized by uncontrollable emotional episodes disconnected or disproportionate with mood, in association with an array of neurologic conditions. PBA is associated with disruption of descending control of brainstem motor circuitry and dysregulation of serotonergic and glutamatergic function. PBA has been historically under recognized, though advances resulting in more specific diagnostic criteria, validated rating scales, and an approved pharmacotherapy offer opportunities for improved treatment outcomes.

Keywords: Alzheimer's disease; Amyotrophic lateral sclerosis; Dextromethorphan; Multiple sclerosis; Parkinson's disease; Pathologic laughing and crying; Pseudobulbar affect; Stroke; Traumatic brain injury.

Publication types

  • Review

MeSH terms

  • Affective Symptoms / drug therapy*
  • Affective Symptoms / physiopathology*
  • Affective Symptoms / psychology
  • Brain Stem / drug effects
  • Brain Stem / physiopathology
  • Clinical Trials as Topic / methods
  • Humans
  • Mood Disorders / drug therapy*
  • Mood Disorders / physiopathology*
  • Mood Disorders / psychology
  • Motor Cortex / drug effects
  • Motor Cortex / physiopathology
  • Pseudobulbar Palsy / drug therapy*
  • Pseudobulbar Palsy / physiopathology*
  • Pseudobulbar Palsy / psychology
  • Psychopharmacology
  • Psychotropic Drugs / pharmacology
  • Psychotropic Drugs / therapeutic use


  • Psychotropic Drugs