Comparing effects of methylphenidate, sertraline and placebo on neuropsychiatric sequelae in patients with traumatic brain injury

Lee, Hoon; Kim, Sung‐Wan; Kim, Jae-Min; Shin, Il‐Seon; Yang, Su-Jin; Yoon, Jin‐Sang

doi:10.1002/hup.668

Cited by 183 publications

(134 citation statements)

References 42 publications

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“…As can be seen in Figure 4 the overall effect across studies was in favour of the control group, with only 3 treatment-control comparisons producing effect sizes suggesting a positive effect of treatment. Consistent with pre-post comparisons, the findings suggest that amitriptyline is the least effective of the treatments trialled (Saran 1985;Dinan 1992), with mixed results for sertraline (Lee, Kim et al 2005;). The largest positive effect was found for methylphenidate (Lee, Kim et al 2005), followed by sertraline (Lee, Kim et al 2005) and group format CBT (Leonard 2002).…”

Section: Controlled Comparisonsmentioning

confidence: 53%

“…Furthermore, weeks of treatment provided in the study with the high positive effect (7 weeks) was midway between that of the remaining studies (4 and 10 weeks). Methylphenidate (Lee, Kim et al 2005) was the only other pharmacological treatment to have an effect size greater than the pooled estimate. Citalopram , milnacipran (Kanetani, Kimura et al 2003) and fluoxetine (Horsfield 2002) produced effect sizes close to the pooled estimate.…”

Section: Insert Table 2 and Figure 2 Around Herementioning

confidence: 80%

“…Two similar sized trials of sertraline (Lee, Kim et ) while the third had a maximum dose of 100 mg/week (Lee, Kim et al 2005). Furthermore, weeks of treatment provided in the study with the high positive effect (7 weeks) was midway between that of the remaining studies (4 and 10 weeks).…”

Section: Insert Table 2 and Figure 2 Around Herementioning

confidence: 99%

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Treatment for depression following mild traumatic brain injury in adults: A meta-analysis

2013

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Primary Objective: Development of depression after TBI is linked to poorer outcomes. The aim of this manuscript is to review evidence for the effectiveness of current treatments.Research Design: Two meta-analyses were undertaken to examine the effectiveness of both pharmacological and non-pharmacological interventions for depression after mild -TBI Method and Procedures: PubMed, Medline, PsychInfo, Web of Science, and Digital Dissertations were searched and 13 studies located. Meta Analyst Beta 3.13 was used to conduct analyses of pre versus post effects then to examine treatment group versus control group effects. Main Outcomes and Results:Studies using a pre-post design produced an overall effect size of 1.89 (95% CI 1.20-2.58, p<.001), suggesting that treatments were effective, however the overall effect for controlled trials was 0.46 (95%CI -0.44-1.36, p<.001), which favoured the control rather than treatment groups. Conclusions:This study highlights the need for additional large well controlled trials of effective treatments for depression post-TBI.

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Section: Controlled Comparisonsmentioning

confidence: 53%

Section: Insert Table 2 and Figure 2 Around Herementioning

confidence: 80%

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Treatment for depression following mild traumatic brain injury in adults: A meta-analysis

2013

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“…Em geral, os resultados sugerem a utilidade do metilfenidato na melhora de memória, atenção, concentração e velocidade do processamento mental, embora nem todos os aspectos sejam evidenciados ao mesmo tempo e em todos os estudos (Napolitano et al, 2005;Lee et al, 2005;Plenger et al,1996;Whyte et al, 1997Whyte et al, e 2004. Além do mais, alguns estudos mostram resultados negativos (Speech et al, 1993;Mooney e Haas, 1993).…”

Section: Discussionunclassified

“…Além do mais, alguns estudos mostram resultados negativos (Speech et al, 1993;Mooney e Haas, 1993). Esses efeitos parecem ser independentes da atuação em sintomatologia depressiva associada (Lee et al, 2005).…”

Section: Discussionunclassified

Emprego de metilfenidato para o tratamento de déficit cognitivo em paciente com seqüela de traumatismo cranioencefálico

Rocha¹,

Malloy-Diniz

Hara

2006

J. bras. psiquiatr.

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ResumoO traumatismo craniencefálico (TCE) é a principal causa de morte e deficiência em jovens. Déficits da atenção e das funções executivas são freqüentemente relatados após comprometimentos do córtex pré-frontal. Os autores relatam um caso de emprego do metilfenidato para o tratamento de alterações cognitivas em paciente com cerca de dois anos de evolução pós-TCE. Com dois meses de tratamento, o paciente relatou melhora significativa de suas dificuldades cognitivas, com maior poder de concentração na leitura, melhor capacidade de manter a atenção em conversas e filmes, além de redução do número de vezes em que perdia objetos. Como efeito colateral, houve um pequeno aumento da irritabilidade nas primeiras duas semanas de tratamento. Ao exame neuropsicológico, constatou-se melhora substancial nas medidas de velocidade de processamento, nos erros por omissão e nos erros por comissão. Palavras-chave: metilfenidato, traumatismo craniencefálico, déficit cognitivo, avaliação neuropsicológica. AbstractTraumatic brain injury is the main cause of death and disability among young people. Attention deficits and executive dysfunction occur frequently after prefrontal cortex damage. The authors report a case of methylphenidate use for the treatment of cognitive deficits in a patient with a two-year evolution of traumatic brain injury. After two months, the patient reported significant improvement in his cognitive deficits, with increased ability to pay attention to reading, talking, watching films and reduction in the frequency of losing objects. As a side effect, he complained of a small increase in irritability in the first two weeks. The neuropsychological assessment showed a substantial improvement in the mental processing speed, in the omission errors and in the commission errors.

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Association of Pharmacological Interventions With Symptom Burden Reduction in Patients With Mild Traumatic Brain Injury

et al. 2021

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IMPORTANCE Mild traumatic brain injury (TBI) is experienced by 55.9 million people globally each year. The symptoms of mild TBI are diverse and sometimes long-lasting, requiring frequent use of pharmacological interventions to mitigate them. A thorough understanding of the data supporting pharmacological interventions is important for decision-making among clinicians treating this common injury.OBJECTIVE To systematically review studies of pharmacological interventions and their associations with symptom burden reduction among patients with mild TBI and to use an evidence-based model to identify potential directions for future research that may aid in clinical decision-making.EVIDENCE REVIEW A systematic review was performed in PubMed, Scopus, and Web of Science. Search strings modified for the advanced search interfaces of each search engine were developed in consultation with a librarian and included combinations of search terms, such as brain concussion, post-concussion syndrome, mild traumatic brain injury, and pharmacological treatment. Articles published between January 1, 2000, and July 1, 2020, were analyzed. Studies were included if (1) they were clinical studies with discrete analyses of participants with mild TBI or complicated mild TBI, (2) they were assessments of a pharmacological intervention, (3) they included human participants, and (4) they were published in a peer-reviewed journal in the English language. Studies were excluded if the severity of TBI among participants could not be ascertained (ie, inadequate definition of mild TBI) and the inclusion criteria for the study required intracranial hemorrhage. A total of 23 studies examining 20 pharmacological interventions met the inclusion criteria. Risk of bias was assessed using the Cochrane Risk of Bias for Randomized Trials (for randomized clinical trials) and the Cochrane Risk of Bias in Non-Randomized Studies of Interventions (for all other studies). Data were analyzed from June to September 2020.FINDINGS A total of 1495 articles were identified; of those, 131 articles were excluded as duplicates. Titles and abstracts were screened for inclusion and exclusion criteria among the remaining 1364 articles, and 134 of those articles received a full-text review. After exclusions, 23 studies (11 randomized clinical trials, 7 prospective observational studies, 3 retrospective observational studies, and 2 case studies) examining 20 pharmacological interventions were identified for inclusion in the systematic review. Studies included 22 distinct participant populations comprising 8277 participants with mild TBI and 45 participants without TBI. Among 23 total studies, 8 studies specifically addressed the pediatric population, 9 studies had a low risk of bias, and 16 studies reported symptom burden reduction. Of the 20 pharmacological interventions examined in the studies, methylphenidate, sertraline hydrochloride, ondansetron, amitriptyline, and melatonin were the only medications included in multiple studies.CONCLUSIONS AND RELEVANCE This systematic r...

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Comparing effects of methylphenidate, sertraline and placebo on neuropsychiatric sequelae in patients with traumatic brain injury

Abstract: Methylphenidate and sertraline had similar effects on depressive symptoms. However, methylphenidate seemed to be more beneficial in improving cognitive function and maintaining daytime alertness. Methylphenidate also offered a better tolerability than sertraline.

Cited by 183 publications

References 42 publications

Treatment for depression following mild traumatic brain injury in adults: A meta-analysis

Treatment for depression following mild traumatic brain injury in adults: A meta-analysis

Emprego de metilfenidato para o tratamento de déficit cognitivo em paciente com seqüela de traumatismo cranioencefálico

Association of Pharmacological Interventions With Symptom Burden Reduction in Patients With Mild Traumatic Brain Injury

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