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Treatment of Poststroke Pathologic Laughing With Duloxetine: A Case Series

 Sang Hoon Shin  ;  Yong Wook Kim  ;  Na Young Kim 
 CLINICAL NEUROPHARMACOLOGY, Vol.42(2) : 60-63, 2019 
Journal Title
Issue Date
Adult ; Duloxetine Hydrochloride/therapeutic use ; Female ; Humans ; Laughter/psychology ; Male ; Middle Aged ; Serotonin and Noradrenaline Reuptake Inhibitors/therapeutic use ; Stroke/complications ; Stroke/drug therapy ; Stroke/psychology ; Treatment Outcome
OBJECTIVES: Pathologic laughing is characterized by episodes of uncontrollable laughter caused by underlying neurologic disturbances, such as stroke. Several types of medication, including selective serotonin reuptake inhibitors, have demonstrated only limited success at treating the condition. Duloxetine, a dual serotonin-norepinephrine reuptake inhibitor, is reportedly effective in treating the symptoms of mood disorders. We herein introduce a prospective consecutive sample of stroke patients with pathologic laughing treated with duloxetine. METHODS: We enrolled patients without a history of psychological illness who exhibited poststroke pathologic laughter. Duloxetine administration was commenced at an initial dose of 30 mg once daily. The dose was increased to 60 mg once daily within 2 weeks for all patients except 2. The effect of the treatment was assessed by means of the Pathological Laughter and Crying Scale. RESULTS: A total of 7 patients were included in the study. Improvements were observed within an average of 10 days after duloxetine administration. Pathological Laughter and Crying Scale score decreased after duloxetine administration in all patients, and 4 patients demonstrated a decrease in score of more than 50%. All patients reported subjective improvement of symptoms, and no adverse effects were observed. CONCLUSIONS: This case series demonstrates that duloxetine could attenuate pathologic laughing exhibited by stroke patients; however, further randomized controlled studies are necessary to validate our findings.
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1. College of Medicine (의과대학) > Dept. of Rehabilitation Medicine (재활의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Na Young(김나영) ORCID logo https://orcid.org/0000-0001-9888-3953
Kim, Yong Wook(김용욱) ORCID logo https://orcid.org/0000-0002-5234-2454
Shin, Sang Hoon(신상훈)
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