Pseudobulbar affect is a debilitating condition that significantly reduces quality of life for many individuals following traumatic brain injury (TBI). It is characterized by embarrassing and often uncontrollable episodes of crying or laughter. The aim of this systematic review was to evaluate the effectiveness of pharmacotherapy as compared to all other comparators for the management of pseudobulbar affect in adults who have sustained TBI. Six databases were searched, with additional hand searching of journals, clinical trials registries and international drug regulators to identify published and unpublished studies in English up to June 2018. Studies were eligible for this review if they included adults who had sustained a medically confirmed TBI and presented with pseudobulbar affect. All pharmacotherapy and comparator interventions were considered for inclusion, and study design was not limited to randomised controlled trials. Evidence quality was assessed using Joanna Briggs Institute Critical Appraisal Instruments. Two quasi-experimental studies examining the effectiveness of dextrometamorphan/quinidine (DM/Q) were identified. These studies reported that DM/Q was effective in reducing symptoms of pseudobulbar affect and had a positive safety profile, over follow-up periods of 3 months (n = 87) and 12 months (n = 23). However, both studies were limited by lack of a control group and a high dropout rate. The findings of twelve case reports examining the effectiveness of DM/Q (n = 6) and anti-depressants (n = 6) are also discussed. Further research is required to determine which pharmacological interventions provide the best outcomes for individuals with pseudobulbar affect following TBI, with consideration given to side effect profiles and financial costs.

中文翻译：

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药物治疗假性颅脑外伤的个人遭受了颅脑外伤：系统评价。

假鳞茎的影响是一种使人衰弱的疾病，它会严重降低颅脑损伤（TBI）后许多人的生活质量。它的特征是令人尴尬且常常无法控制的哭声或笑声发作。这项系统评价的目的是评估与所有其他比较药物相比，对于患有持续性TBI的成年人而言，假药治疗的有效性。搜索了六个数据库，并手动搜索了期刊，临床试验注册机构和国际药物监管机构，以识别截至2018年6月为止英文版的已发表和未发表的研究。如果研究包括经医学证实的TBI和表现出假性球感。所有药物治疗和比较药物干预措施均纳入考虑范围，研究设计不仅限于随机对照试验。证据质量使用Joanna Briggs Institute关键评估工具进行评估。鉴定了两项检查右旋吗啡/奎尼丁（DM / Q）有效性的准实验研究。这些研究报告称，在3个月的随访期内，DM / Q可有效减轻假性球囊扩张症状，并具有积极的安全性（n  = 87）和12个月（n  = 23）。但是，两项研究均因缺乏对照组和辍学率高而受到限制。 还讨论了十二个检查DM / Q（n  = 6）和抗抑郁药（n = 6）有效性的病例报告的结果。需要进一步的研究来确定哪种药理学干预措施能为TBI后的假性球囊疾病患者提供最佳的治疗效果，同时要考虑到副作用和财务费用。