[Michelle Hess]

Has anyone every prescribed or used dextromethorphan transdermally in cream form for the innappropriate giggling or crying that comes with pseudo bulbar affect? Apparently Dextromethorphan is coupled with quinidine in the new pseudo bulbar drug Nuedexta. But quinidine is not without potential side effects and contraindications and its only reason in the formulation is to increase the level of the DM so that it has less first-pass effect in the liver.

so my question is if anyone has ever used DM alone transdermally for this use?? Transdermally, it would undergo less metabolism to its inactive/unable to pass blood brain barrier metabolite. it just makes sense to try. Anyone have any thoughts on this?