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What Medications Are Used to Treat Traumatic Brain Injury?

doctor showing tbi patient medications used for traumatic brain injury

There are many medications that can be used to treat the effects of traumatic brain injury.

While medications should never replace rehabilitative therapies, they can act as a support for recovery and relieve many of the more pain-related outcomes of TBI.

This article will discuss some of the most commonly used medications amongst traumatic brain injury survivors and their effects.

Medications Used for Traumatic Brain Injury

Medications can address several problems associated with brain injury, from mood disorders to physical pain.

There are currently no drugs that are FDA-approved to treat the effects of traumatic brain injury, which means the medications listed below are all “off-label.”

It should also be noted that many of these drugs can have negative side effects. Therefore, the decision to start any medication should be carefully considered with the help of your doctor.

Here are some of the most common types of medications used to treat traumatic brain injury:

1. Psychostimulants

These medications are frequently used to improve cognitive functioning after traumatic brain injury.

Psychostimulants, such as methylphenidate, increase frontal lobe activity in patients who have trouble with self-regulation and self-control. They can also improve alertness and depressive symptoms

While methylphenidate is primarily used to treat ADHD, there are enough similarities between ADHD and frontal lobe brain damage that doctors often prescribe it to their TBI patients.

Studies indicate that methylphenidate causes a significant improvement in attention spans in brain injury patients. However, it does not seem to improve memory or processing speeds.

Other stimulants that doctors can prescribe for traumatic brain injury patients include Modafinil, which helps boost alertness and combats extreme cognitive fatigue.

2. Antidepressants

medications for traumatic brain injury

Depression is a common secondary effect of brain injury, and antidepressants may be prescribed to alleviate symptoms.

To be diagnosed with clinical depression, a person must experience at least two weeks of feeling sad or apathetic, plus four or more of the following symptoms:

  • Significant weight loss or weight gain (5 percent or more in one month)
  • Insomnia or sleeping too much
  • Motor agitation or slowing (making strange movements without meaning to)
  • Extreme fatigue
  • Feelings of worthlessness
  • Decreased concentration or indecisiveness
  • Thoughts of death or suicide

The most common antidepressants prescribed to brain injury patients are:

  • Fluoxetine hydrochloride (Prozac)
  • Sertraline (Zoloft)
  • Fluvoxamine (Luvox)
  • Venlafaxine (Effexor)

Some antidepressant medications can cause sedation which can worsen cognitive dysfunction. Talk to your doctor before trying any.

However, other antidepressants, especially SSRIs like Prozac, can boost serotonin activity in the brain, which may improve cognitive function.

3. Antiparkinson Agents

Antiparkinson agents are medications that are frequently used to combat the effects of brain injury. These drugs have varied mechanisms, but they all serve to increase dopamine levels in the brain.

Amantadine is an antiparkinson medication that may be beneficial for brain injury survivors.

Patients treated with amantadine showed improvements across multiple cognitive functions, including:

  • Decreased apathy
  • Increased attention, concentration, and arousal
  • Improved executive functioning
  • Faster processing time
  • Reduced agitation, aggression, and anxiety

In a major, placebo-controlled trial, amantadine-treated TBI patients made a significantly faster recovery than those receiving a placebo.

4. Antispasmodic Medications

doctor injecting botox into patient's arm

Antispasmodic medications can help temporarily relieve stiff muscles after brain injury.

The most common types of antispasticity drugs for TBI patients are:

  • Tizanidine hydrochloride (Zanaflex). Tizanidine is an oral muscle relaxant. One dose of 8 mg reduces muscle tone in spasticity patients for several hours.
  • Baclofen. Baclofen works by activating GABA B receptors, which produce a calming effect on the central nervous system. It can either be taken orally or delivered intrathecally through a spinal port.
  • Botox. Botox blocks the nerve signals that cause muscles to contract. It is injected directly into the spastic muscle and compared to oral medications, has long-lasting effects (~3-6 months).

While these drugs can provide temporary spasticity relief, they will not cure it. The only way to promote long-term spasticity relief is to promote neuroadaptive changes by repetitively using the affected muscles. This will help reinforce demand for those functions in the brain and encourage neural rewiring.

Learn how to overcome spasticity after TBI»

5. Pain Medications

Pain management is an important part of traumatic brain injury recovery.

However, strong pain medications, such as opiates and narcotics, are not usually the solution to pain after TBI. That’s because these drugs work by suppressing brain activity, which can be dangerous for brain injury survivors who already have impaired brain function.

Non-opioid analgesics such as acetaminophen and naproxen are generally safe for TBI patients. Ibuprofen is also a good option, but do not take it within the first week or two after a head injury, as it can increase your risk of bleeding.

If your pain is too much to bear, talk to your doctor. Stronger pain meds taken for only a short period might be able to help without causing any long-term cognitive damage.

Medications Used for Brain Injury: Key Points

Traumatic brain injury causes many cognitive, emotional, and physical secondary effects that can be difficult to live with.

Medications can often help take the edge off these symptoms and allow patients to function again. However, while they can help promote recovery, they are no substitute for the hard work of consistent therapy.

Drugs such as the ones listed above only treat the symptoms of brain injury. But to fully recover from TBI, you will need to engage your brain’s natural repair mechanism, neuroplasticity. You do this through repetitive practice.

By combining modern medications with frequent physical therapy, you can increase your chances of making a great recovery.

Featured image: ©iStock.com/SARINYAPINNGAM

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