Cognitive Impairment with Traumatic Brain Injury

Traumatic brain injury can significantly impact an individual’s life, in terms of cognitive, behavioral and physical impairments. Among these, cognitive impairments are often the most disabling & can impair the activities of daily living.

Traumatic brain Injury can cause cognitive impairments, including impairments of attention, processing speed, episodic memory, and executive function. Non-Pharmacologic interventions are considered first line for the treatment of these cognitive impairments.

Pharmacological treatment should be used as an adjunct to non-pharmacologic interventions.

Which of the following medication(s) can be used for the treatment of cognitive impairment with traumatic brain injury?

Answer: Amantadine, Methylphenidate and Donepezil.

Amantadine is one of the commonly prescribed medications for patients post-trauma cognitive difficulties undergoing inpatient neuro-rehabilitation.

  • Because of its affect on both dopamine and N-methyl-D-aspartate (NMDA) channels, amantadine has been the subject of considerable interest and clinical use in acute TBI.

Methylphenidate is the first-line medication from stimulant class.

  • During the subacute and late post-injury period: methylphenidate may improve hypoarousal, attention, processing speed and general cognitive function.

Donepezil is centrally selective acetylcholinesterase inhibitor.

  • Donepezil increases neuropsychologic testing scores in short-term memory and sustained attention in post-acute TBI patients.

Read Course Chapter for More Details:

Treatment of Cognitive Impairment with Traumatic Brain Injury

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TRAUMATIC BRAIN INJURY (TBI)

(1) Treatment of Depression after Traumatic Brain Injury

This chapter will focus on the following topics:

  • Classification of Renal Impairment Stages
  • SSRIs, SNRIs, NDRI
  • Serotonin Modulators
  • NaSSAs
  • NRI
  • TCA
  • MAOIs

(This Chapter is Available for Free Preview)

(2) Treatment of Aggression with Traumatic Brain Injury

This chapter will focus on the following topics:

  • Which medications are preferred for mood stabilization in patient with TBI.
  • Dosage of each medication: found effective for reduction in either agitation, aggressiveness or disinhibition.
  • How early to expect response from these medications?

(3) Treatment of Cognitive Impairment with Traumatic Brain Injury

This chapter will focus on the following topics:

  • Pre-requisite before initiating pharmacologic treatment.
  • Establishing the severity of TBI.
  • Available five pharmacological treatment options.

(4) Treatment of Insomnia with Traumatic Brain Injury

This chapter will focus on the following topics:

  • Which medications are preferred for insomnia management in patient with TBI.
  • Which medications should be avoided?

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