Research Article
No access
Published Online: 4 October 2006

Guidelines for the Pharmacologic Treatment of Neurobehavioral Sequelae of Traumatic Brain Injury

Publication: Journal of Neurotrauma
Volume 23, Issue Number 10

Abstract

There is currently a lack of evidence-based guidelines to guide the pharmacological treatment of neurobehavioral problems that commonly occur after traumatic brain injury (TBI). It was our objective to review the current literature on the pharmacological treatment of neurobehavioral problems after traumatic brain injury in three key areas: aggression, cognitive disorders, and affective disorders/anxiety/ psychosis. Three panels of leading researchers in the field of brain injury were formed to review the current literature on pharmacological treatment for TBI sequelae in the topic areas of affective/anxiety/ psychotic disorders, cognitive disorders, and aggression. A comprehensive Medline literature search was performed by each group to establish the groups of pertinent articles. Additional articles were obtained from bibliography searches of the primary articles. Group members then independently reviewed the articles and established a consensus rating. Despite reviewing a significant number of studies on drug treatment of neurobehavioral sequelae after TBI, the quality of evidence did not support any treatment standards and few guidelines due to a number of recurrent methodological problems. Guidelines were established for the use of methylphenidate in the treatment of deficits in attention and speed of information processing, as well as for the use of beta-blockers for the treatment of aggression following TBI. Options were recommended in the treatment of depression, bipolar disorder/mania, psychosis, aggression, general cognitive functions, and deficits in attention, speed of processing, and memory after TBI. The evidence-based guidelines and options established by this working group may help to guide the pharmacological treatment of the person experiencing neurobehavioral sequelae following TBI. There is a clear need for well-designed randomized controlled trials in the treatment of these common problems after TBI in order to establish definitive treatment standards for this patient population.

Get full access to this article

View all available purchase options and get full access to this article.

Information & Authors

Information

Published In

cover image Journal of Neurotrauma
Journal of Neurotrauma
Volume 23Issue Number 10October 2006
Pages: 1468 - 1501
PubMed: 17020483

History

Published online: 4 October 2006
Published in print: October 2006

Permissions

Request permissions for this article.

Topics

Authors

Affiliations

Deborah L. Warden
Defense and Veterans Brain Injury Center, Departments of Neurology and Neurosurgery, Walter Reed Army Medical Center, and Departments of Neurology and Psychiatry, Uniformed Services University of the Health Sciences, Washington, DC.
Barry Gordon
Departments of Neurology and Cognitive Science, The Johns Hopkins University, Baltimore, Maryland.
Thomas W. McAllister
Departments of Psychiatry and Neuropsychiatry, Dartmouth Medical School, Lebanon, New Hampshire.
Jonathan M. Silver
Department of Psychiatry, New York University School of Medicine, New York, New York.
Jeffery T. Barth
Departments of Psychiatric Medicine and Neurological Surgery, University of Virginia School of Medicine, Charlottesville, Virginia.
John Bruns
Department of Emergency Medicine, Mount Sinai School of Medicine, New York, New York.
Angela Drake
Defense and Veterans Brain Injury Center, San Diego Naval Medical Center, San Diego, California.
Tony Gentry
Partnership for People with Disabilities, Department of Education, Virginia Commonwealth University, Richmond, Virginia.
Andy Jagoda
Department of Emergency Medicine, Mount Sinai School of Medicine, New York, New York.
Douglas I. Katz
Department of Neurology, Boston University School of Medicine, Boston Massachusetts, and Brain Injury Programs, Healthsouth Braintree Rehabilitation Hospital, Braintree, Massachusetts.
Jess Kraus
Department of Epidemiology, UCLA School of Public Health, Los Angeles, California.
Lawrence A. Labbate
Department of Psychiatry, University of Arkansas for Medical Sciences and VA Medical Center, North Little Rock, Little Rock, Arkansas.
Laurie M. Ryan
Defense and Veterans Brain Injury Center, Department of Neurology, Walter Reed Army Medical Center and Department of Neurology, Uniformed Services University of the Health Sciences, Washington, DC.
Molly B. Sparling
Defense and Veterans Brain Injury Center, Department of Neurology, Walter Reed Army Medical Center, Washington, DC.
Beverly Walters
Department of Neurosurgery, New York University School of Medicine, New York, New York.
John Whyte
Moss Rehabilitation Research Institute, Albert Einstein Healthcare Network and Department of Rehabilitation Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania.
Ashley Zapata
Medical College of Virginia, Virginia Commonwealth University, Richmond, Virginia.
George Zitnay
Laurel Highlands Neuro-Rehabilitation and Defense and Veterans Brain Injury Center, Walter Reed Army Medical Center, Washington, DC.

Metrics & Citations

Metrics

Citations

Export citation

Select the format you want to export the citations of this publication.

View Options

Get Access

Access content

To read the fulltext, please use one of the options below to sign in or purchase access.

Society Access

If you are a member of a society that has access to this content please log in via your society website and then return to this publication.

Restore your content access

Enter your email address to restore your content access:

Note: This functionality works only for purchases done as a guest. If you already have an account, log in to access the content to which you are entitled.

View options

PDF/EPUB

View PDF/ePub

Media

Figures

Other

Tables

Share

Share

Copy the content Link

Share on social media

Back to Top