Rapid response of emotional incontinence to selective serotonin reuptake inhibitors

Emotional incontinence (EI) is a perturbing condition characterized by uncontrollable outbursts of exaggerated, involuntary facial expressions and pathological crying or laughter. There is increasing evidence that serotonergic neurotransmission may be damaged in EI. The authors report 4 pathological crying cases (3 poststroke and 1 with multiple sclerosis) and 1 case of pathological laughter after traumatic brain injury. EI improved dramatically with three different selective serotonin reuptake inhibitors (fluoxetine, sertraline, and paroxetine) in the context of these different CNS diseases.