Dementia in Head Injury (cont.)
IN THIS ARTICLE
Persons with head injury may require medication to treat symptoms such as depression, mania, psychosis, aggression, irritability, mood swings, insomnia, apathy, or impaired concentration. Headaches may also get better with drug treatment.
Drugs used to treat such symptoms are called psychotropic or psychoactive drugs. They work by changing the way the brain works. Head-injured persons are more sensitive to drug side effects. Doses and schedules may require frequent adjustment until the best regimen is found.
Most people with dementia due to head injury are treated with the same drugs used to treat dementia of other causes. In many cases, these drugs have not been specifically tested in persons with head injury. There are no established guidelines on psychotropic drug treatment after head injury.
These drugs are used to treat depressive symptoms due to head injury.
These drugs increase the amount of a brain chemical (neurotransmitter) called dopamine.
These drugs are used to treat psychotic symptoms such as agitation, delusions, and hallucinations.
These drugs often work well in behavior disturbances (aggression, agitation) that occur as complications of head injury. They work by stabilizing mood. Examples include carbamazepine (Tegretol) and valproic acid (Depacon, Depakene, Depakote).
Like some antiepileptic agents, the drug lithium (Eskalith, Lithobid) is a mood stabilizer. It is helpful in calming explosive and violent behavior. Lithium also decreases impulsive and aggressive behavior.
These drugs quickly relieve agitation or violence in dementia. They have other uses, such as treating insomnia and relieving anxiety. Because they can worsen cognitive problems, they are not recommended in head-injured persons with dementia except to as needed to calm a person rapidly. Examples are lorazepam (Ativan) and diazepam (Valium).
These drugs work well in treating aggression in some people with head injury. They also reduce restlessness and agitation. An example of these drugs, which are most widely used to lower high blood pressure, is propranolol (Inderal).
Medically Reviewed by a Doctor on 7/23/2014
Julia Frank, MD
Nestor Galvez-Jimenez, MD
Francisco Talavera, PharmD, PhD
Helmi L Lutsep, MD
Must Read Articles Related to Dementia in Head Injury
Read What Your Physician is Reading on Medscape
Traumatic brain injury can lead to deficits in 5 general areas: (1) short-term memory impairment, (2) slowed processing speed, (3) impaired executive function, (4) disrupted abilities of attention and concentration (which likely contributes to the deficits noted in the first 3 categories), and (5) emotional dysregulation.