Beyond Tears: Understanding What is the Drug for Crying and Associated Conditions

October 10, 2025 •

4 min read

According to the American Journal of Managed Care, Pseudobulbar Affect (PBA), a condition causing uncontrollable laughing or crying, is estimated to affect up to 2 million people in the United States. For this and other conditions, people often ask: What is the drug for crying? The answer is not simple, as it depends on the underlying cause of the emotional display.

Quick Summary

This article explores the different medical conditions and medications that can affect crying, including the FDA-approved treatment for Pseudobulbar Affect (PBA), known as Nuedexta. It also discusses emotional blunting as a side effect of some antidepressants and highlights the need for a professional diagnosis for appropriate treatment.

Key Points

Pseudobulbar Affect (PBA): Uncontrollable and disproportionate episodes of crying or laughing caused by a neurological condition, not a mental health issue.
Nuedexta (Dextromethorphan/Quinidine): The only FDA-approved medication specifically for PBA, working to regulate emotional pathways in the brain.
Off-Label Antidepressants: SSRIs (e.g., Zoloft) and TCAs (e.g., Elavil) are sometimes used at lower doses to treat PBA.
Emotional Blunting: A side effect of some antidepressants, particularly SSRIs, that can cause a reduced ability to feel and express emotions, including crying.
Substance Withdrawal: Excessive tearfulness can be a symptom of withdrawing from certain drugs, such as cocaine, due to shifts in the brain's reward system.
Professional Diagnosis is Key: The correct treatment for a 'drug for crying' depends on the underlying cause and requires a thorough evaluation by a healthcare provider.

Crying can be a normal, healthy human response to sadness, joy, or stress. However, when crying becomes uncontrollable, disproportionate to the circumstances, or occurs without a trigger, it can be a sign of a medical condition. In these specific instances, pharmacological interventions may be used to help manage the symptoms. The appropriate 'drug for crying' depends entirely on the specific underlying condition, which a healthcare professional must diagnose.

Pseudobulbar Affect (PBA): The Primary Condition for a 'Crying Drug'

PBA is a neurological condition characterized by sudden, frequent, and involuntary episodes of laughing, crying, or both. These emotional outbursts are often exaggerated or don't align with how the person truly feels, leading to significant embarrassment and social distress. PBA is not a mental illness but a result of neurological damage from an underlying condition that disrupts the brain's circuitry for emotional regulation.

Some conditions commonly associated with PBA include:

Amyotrophic Lateral Sclerosis (ALS)
Multiple Sclerosis (MS)
Traumatic Brain Injury (TBI)
Stroke
Parkinson's Disease
Alzheimer's Disease

Nuedexta: The FDA-Approved Treatment for PBA

The only medication specifically approved by the U.S. Food and Drug Administration (FDA) to treat PBA is a combination of dextromethorphan hydrobromide and quinidine sulfate, sold under the brand name Nuedexta®.

Mechanism of Action:

Dextromethorphan is a cough suppressant that also acts on the central nervous system as an NMDA receptor antagonist and a sigma-1 receptor agonist. The exact way it helps with PBA is not fully understood, but its effect modulates brain signals that control emotional expression.
Quinidine is used to increase the levels of dextromethorphan in the body by inhibiting its metabolism, allowing it to have its therapeutic effect.

Clinical trials have shown that Nuedexta can significantly reduce the frequency and severity of laughing and crying episodes in patients with PBA.

Off-Label Treatments for PBA

Before Nuedexta was approved, and still sometimes today, doctors would prescribe other medications off-label to manage PBA symptoms. Off-label use is when a drug is prescribed for a condition other than its FDA-approved indication.

Common off-label treatments for PBA include:

Selective Serotonin Reuptake Inhibitors (SSRIs): Such as sertraline (Zoloft) and fluoxetine (Prozac). These are often prescribed at lower doses for PBA than for depression.
Tricyclic Antidepressants (TCAs): Such as amitriptyline (Elavil) and nortriptyline (Pamelor). Like SSRIs, these are typically used at lower doses for PBA.

Emotional Blunting as a Side Effect of Medications

In some cases, the question of a "drug for crying" relates to the inability to cry rather than excessive tearfulness. A side effect of certain medications, especially SSRI antidepressants, is emotional blunting, a reduction or flattening of emotional responses. This can make it difficult for an individual to feel emotions fully, whether positive or negative, and may suppress their ability to cry.

This is a potential side effect for those taking antidepressants to treat conditions like depression and anxiety. It's important to differentiate this side effect from the symptoms of PBA. If you experience emotional blunting, it's crucial to consult your doctor. They may adjust your dosage or switch your medication, but you should never stop taking a prescribed drug on your own.

Crying Associated with Drug Withdrawal

Excessive tearfulness or intense emotional volatility can also be a symptom of withdrawal from certain substances. For example, studies have shown that excessive tearfulness can be a clinical sign of cocaine-induced depression, where a rebound in parasympathetic tone occurs after cessation of use. A wide range of substances can alter mood and brain chemistry, and withdrawal can lead to significant emotional changes, including frequent crying. Treating this requires addressing the substance abuse disorder itself, often with a combination of medical supervision, counseling, and other supportive therapies.

Comparison Table: Understanding Different Pharmaceutical Approaches to Crying


Feature	Pseudobulbar Affect (PBA) Treatment (Nuedexta)	Emotional Blunting (SSRI Side Effect) Management	Drug Withdrawal-Related Crying Treatment
Underlying Cause	Neurological damage (e.g., from MS, ALS, stroke) affecting emotional control pathways.	A side effect of medication, often SSRIs, altering brain chemistry and emotional processing.	Cessation of substance use (e.g., cocaine withdrawal) leading to changes in autonomic and emotional regulation.
Primary Treatment Goal	Reduce the frequency and severity of involuntary, disproportionate episodes of crying or laughing.	Reduce or eliminate the sensation of emotional numbness, often by adjusting medication dosage or type.	Treat the substance abuse disorder to allow the brain and body to heal and emotional regulation to normalize.
Key Medications	Dextromethorphan/Quinidine (Nuedexta) is FDA-approved. Off-label use of SSRIs and TCAs is also possible.	Modifying the antidepressant regimen; options may include lowering the dose, switching to a different class (e.g., NDRI like bupropion), or adding an adjunct medication.	Addressing the addiction with supervised detoxification, counseling, and, if needed, medication to manage specific withdrawal symptoms.
Patient Experience	Feeling of losing control over emotions, leading to social distress and embarrassment.	Reduced capacity to feel emotions, both positive and negative, often described as feeling 'numb'.	Can include intense mood swings, depression, anxiety, and excessive tearfulness during the withdrawal period.

Conclusion: Finding the Right Path for Help

There is no single drug for crying, and the need for medication is based on a professional diagnosis of the specific cause of emotional dysregulation. For involuntary, exaggerated episodes, the FDA-approved option is Nuedexta for Pseudobulbar Affect, with off-label antidepressants also being used. In contrast, if medication is causing emotional blunting, a change in treatment is usually recommended. Furthermore, excessive crying can be a symptom of substance withdrawal, requiring a focus on treating the addiction.

It is vital that individuals experiencing unusual or uncontrollable crying consult a healthcare provider. A proper diagnosis can determine whether the cause is neurological (like PBA), a side effect of medication, or related to substance use, ensuring the most effective and safest treatment plan.

For more information on Pseudobulbar Affect, see the Mayo Clinic's overview of the condition: Pseudobulbar Affect - Diagnosis and treatment.

Frequently Asked Questions

Emotional crying is a voluntary and proportionate response to genuine feelings, while PBA-related crying is involuntary, often exaggerated, and can be completely disconnected from the person's internal emotional state.

Nuedexta works by combining dextromethorphan, which modulates emotional brain signals, and quinidine, which boosts the amount of dextromethorphan in the body to make it more effective in reducing the frequency and severity of crying episodes.

Yes, some antidepressants, including SSRIs and TCAs, are used off-label to treat PBA, often at lower doses than those used for depression. However, Nuedexta is the only FDA-approved drug specifically for this purpose.

Emotional blunting is often a temporary side effect and can be managed by adjusting the dosage or switching to a different medication under a doctor's supervision.

Yes, certain types of substance withdrawal, such as from cocaine, can cause excessive tearfulness due to the brain's altered chemistry and a rebound effect in the parasympathetic nervous system.

PBA is diagnosed by a healthcare provider, often a neurologist or psychiatrist, who evaluates the patient's symptoms, including the frequency and nature of the emotional outbursts. They will distinguish it from mood disorders like depression.

If you experience sudden, uncontrollable, or exaggerated episodes of crying, you should consult a doctor, such as a neurologist, to get a proper diagnosis and discuss appropriate treatment options.