Twenty Years of Pharmacology

Abstract

During the past 20 years in pharmacology, a number of innovations have appeared that have resulted in significant changes in the drugs available for people with traumatic brain injury. Among the anticonvulsants, antidepressants, and antipsychotics, new drugs have appeared with fewer cognitive side effects. In these classes of drugs, as well as among central nervous system stimulants, once-daily or other sustained-release preparations have been introduced that make it considerably more likely that the patient will take his or her medication, with smaller fluctuations in drug levels as well. New drugs have also resulted in a greater number of medications for the clinician to choose from. The overall effect has been a dramatic change in pharmacology that has benefited people with traumatic brain injury.

Update on Insomnia after Mild Traumatic Brain Injury

“…Its mechanism in humans remains poorly understood; however, animal models have shown that trazodone inhibits serotonin re-uptake [78]. For TBI patients, trazodone is generally well tolerated and unlike the tricyclic antidepressants, has little to no anticholinergic effect [81]. Compared to Z-drugs, trazodone has a relatively longer half-life at 5–9 h, so daytime sedation is a potential side effect [81].…”

“…For TBI patients, trazodone is generally well tolerated and unlike the tricyclic antidepressants, has little to no anticholinergic effect [81]. Compared to Z-drugs, trazodone has a relatively longer half-life at 5–9 h, so daytime sedation is a potential side effect [81]. Despite trazodone’s usage, there are no clinical trials on trazodone for insomnia treatment in the TBI population.…”

“…Available pharmacologic and non-pharmacologic interventions for treatment of insomnia. [70,71,72,73,74,75,76,77,78,79,80,81,82,83]. …”

Pharmacotherapy for postacute traumatic brain injury: A literature review for guidance in psychological practice.

“…For individuals with memory problems, a sustained release version of methylphenidate may help circumvent the problems associated with inconsistent adherence to the medication regimen. Metadate (effective for 8 -10 hr) and Concerta (effective for about 12 hr) are long-acting forms of methylphenidate and are both possibilities for use in TBI, although no research has evaluated their effectiveness in this population to date (Glenn & Wroblewski, 2005).…”

A review of pharmacological treatments used in experimental models of traumatic brain injury

“…However, the effects of these alternative remedies are difficult to interpret. The standardization and purity of these extracts vary because they lack regulation by the Food and Drug Administration [28]. In addition, many of these alternative medications are readily available and do not require physician inquiry.…”