Treatment of Chronic Closed Head Injury with Psychostimulant Drugs: A Controlled Case Study and an Appropriate Evaluation Procedure

Rw, Evans; Ct, Gualtieri; Patterson, Debra

doi:10.1097/00005053-198702000-00007

Cited by 91 publications

(21 citation statements)

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“…The primary psychostimulant agents considered are methylphenidate (Ritalin), dextroamphetamine (Dexedrine), and pemoline (Cylert). In the adult TBI literature, several case reports support the use of stimulant therapy in treating attentional disorders secondary to brain trauma [17][18][19][20]. Similarly, Stern [21] reported that 8 of 11 patients in his series demonstrated clinical improvement based on rating scales.…”

Section: Discussionmentioning

confidence: 99%

Psychopharmacologic Treatment of Acquired Attention Disorders in Children with Brain Injury

Mahalick

Carmel²,

Greenberg

et al. 1998

Pediatr Neurosurg

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This investigation examined the efficacy of psychostimulant therapy in alleviating neurobehavioral dysfunction attendant to pediatric brain injury. The most commonly reported neurobehavioral sequelae associated with head injury in the pediatric population involve deficits along the attentional matrix. This is also the most common objectively documented neurobehavioral finding among children as well as adults. There are several investigations in the adult literature which have employed the use of psychostimulants in treating both psychiatric and neuropsychological residua associated with head injury. Overall, the results of these studies are equivocal, but suggest a beneficial impact on general functioning. The present prospective investigation utilized a double-blind, placebo-controlled, cross-over experimental design to examine the efficacy of methylphenidate in treating children with acquired attentional disorders secondary to brain injury. A cohort of 14 children with varying degrees of head injury were recruited for participation. As expected, differences between drug and placebo conditions uniformly achieved statistical significance. Additionally, there were no differences in performance between baseline and placebo conditions on neurobehavioral tasks of attention and concentration. Current findings suggest that methylphenidate (and probably other psychostimulants such as Cylert, Adderal, Wellbutrin and dextroamphetamine sulfate) is an extremely effective agent in treating attentional disorders secondary to brain injury in children.

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Section: Discussionmentioning

confidence: 99%

Psychopharmacologic Treatment of Acquired Attention Disorders in Children with Brain Injury

Mahalick

Carmel²,

Greenberg

et al. 1998

Pediatr Neurosurg

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“…In addition, if MDMA and mTBI separately cause cognitive impairments, and many previous studies suggested that MDMA and mTBI share neurodestructive mechanisms, why does the combination of the two factors not have a worsening effect? A report by Evans et al (1987), who administered dextroamphetamine (an amphetamine analog) following closed head TBI, found that it enhanced processing speed time and improved memory. Previous case studies showed that "in hospital" mortality rates were lower in people who consumed amphetamines before accidental TBI (O'Phelan et al 2008).…”

Section: Discussionmentioning

confidence: 99%

The intriguing effects of ecstasy (MDMA) on cognitive function in mice subjected to a minimal traumatic brain injury (mTBI)

et al. 2010

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“…However, a thorough Medline search yielded only a single Class IIIb report to support its use in this population [48]. This report describes improvement in verbal memory and learning skills in response to treatment with either this agent or methylphenidate in a single adult male treated in the late post-injury period.…”

Section: Dextroamphetaminementioning

confidence: 97%

Cognitive impairment following traumatic brain injury

Arciniegas¹,

Held²,

Pk³

2002

Curr Treat Options Neurol

216

140

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Cognitive impairments due to traumatic brain injury (TBI) are substantial sources of morbidity for affected individuals, their family members, and society. Disturbances of attention, memory, and executive functioning are the most common neurocognitive consequences of TBI at all levels of severity. Disturbances of attention and memory are particularly problematic, as disruption of these relatively basic cognitive functions may cause or exacerbate additional disturbances in executive function, communication, and other relatively more complex cognitive functions. Because of the high rate of other physical, neurologic, and psychiatric syndromes following TBI, a thorough neuropsychiatric assessment of the patient is a prerequisite to the prescription of any treatment for impaired cognition. Psychostimulants and other dopaminergically active agents (eg, methylphenidate, dextroamphetamine, amantadine, levodopa/carbidopa, bromocriptine) may modestly improve arousal and speed of information processing, reduce distractibility, and improve some aspects of executive function. Cautious dosing (start-low and go-slow), frequent standardized assessment of effects and side effects, and monitoring for drug-drug interactions are recommended. Cognitive rehabilitation is useful for the treatment of memory impairments following TBI. Cognitive rehabilitation may also be useful for the treatment of impaired attention, interpersonal communication skills, and executive function following TBI. This form of treatment is most useful for patients with mild to moderate cognitive impairments, and may be particularly useful for those who are still relatively functionally independent and motivated to engage in and rehearse these strategies. Psychotherapy (eg, supportive, individual, cognitive-behavioral, group, and family) is an important component of treatment. For patients with medication- and rehabilitation-refractory cognitive impairments, psychotherapy may be needed to assist both patients and families with adjustment to permanent disability.

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Treatment of Chronic Closed Head Injury with Psychostimulant Drugs: A Controlled Case Study and an Appropriate Evaluation Procedure

Cited by 91 publications

References 0 publications

Psychopharmacologic Treatment of Acquired Attention Disorders in Children with Brain Injury

Psychopharmacologic Treatment of Acquired Attention Disorders in Children with Brain Injury

The intriguing effects of ecstasy (MDMA) on cognitive function in mice subjected to a minimal traumatic brain injury (mTBI)

Cognitive impairment following traumatic brain injury

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