EpistemisEmotional lability
Specialty: Psychiatry.
Why it occurs
- Borderline personality disorder (BPD)
- Bipolar disorder (mixed or rapid cycling states)
- Pseudobulbar affective syndrome (secondary to Amyotrophic Lateral Sclerosis, Multiple Sclerosis, stroke or trauma)
- Attention deficit hyperactivity disorder (ADHD) in adults
- Premenstrual dysphoric syndrome (PMDS)
- Consumption or abstinence from alcohol, benzodiazepines or stimulants
Initial workup
Daily mood record (mood graph); affective lability scale (ALS); Brain MRI to rule out demyelinating or vascular lesions of the corticobulbar pathways; Gynecological hormonal profile in suspected PMPS.
red flags
Extreme mood fluctuations that lead to impulsive self-harming behaviors, suicide attempts reactive to minor frustrations, or episodes of uncontrolled aggression against the environment.
Standard management
- Lamotrigine — excellent stabilizer for the emotional instability of BPD and Bipolar Disorder
- Dextromethorphan/Quinidine — specific combination approved for neurological pseudobulbar affection syndrome
- SSRIs such as Sertraline or Fluoxetine — effective in the lability associated with SDPM and TPL
- Sodium valproate — to control impulsivity and affective oscillations
Educational guidance for study. It is NOT a prescription recommendation. The actual choice depends on the cause, the patient, and current guidelines.
- Area
- Psychiatry
- Listed causes
- 6
- Treatment options
- 4