Traumatic brain injury: Pharmacotherapy options for cognitive deficits
Different medication classes improve different areas of cognitive function
CASE CONTINUED: Improvement with stimulants
Unlike many TBI patients who do not recognize the often-subtle psychiatric sequelae of their injury, Mr. A is aware of his difficulty concentrating, which is temporally linked with his accident. After exploring the association between Mr. A’s symptoms and his injury, his psychiatrist concludes that Mr. A’s cognitive deficits likely are associated with his TBI. Mr. A’s history of alcohol abuse raises concerns about prescribing stimulants. However, after assuring that Mr. A’s depression is well controlled and addressing his risk of substance abuse, his psychiatrist prescribes methylphenidate titrated to 30 mg/d. When he returns to the clinic several weeks later, Mr. A reports improved attention and functioning at work, and continues to follow up with the psychiatrist without requiring changes to his medication regimen.
Related Resource
- Konrad C, Geburek AJ, Rist F, et al. Long-term cognitive and emotional consequences of mild traumatic brain injury. Psychol Med. 2010;22:1-15.
Drug Brand Names
- Amantadine • Symadine, Symmetrel
- Bromocriptine • Parlodel
- Carbidopa/levodopa • Sinemet
- Dextroamphetamine • Dexedrine
- Donepezil • Aricept
- Galantamine • Razadyne
- Methylphenidate • Ritalin, Methylin, others
- Physostigmine • Antilirium
- Pramipexole • Mirapex
- Rivastigmine • Exelon
- Sertraline • Zoloft
- Tacrine • Cognex
Disclosures
Dr. Scher and Ms. Loomis report no financial relationship with any company whose products mentioned in this article or with the manufacturers of competing products.
Dr. McCarron is a speaker for Eli Lilly and Company.
