Abstract for presentation at 6th World Congress on Brain Injury

Patterns of Neurologically Active Medication usage during Early Inpatient TBI Rehabilitation

  • Ian Baguley, Westmead Brain Injury Rehabilitation Service, Australia
  • Ms Amanda Lane Brown, Rehabilitation Studies Unit, University of Sydney, Australia
  • Mr Joe Hanna, Rehabilitation Studies Unit, University of Sydney, Australia
  • A/Prof Robyn Tate, Rehabilitation Studies Unit, University of Sydney, Australia
  • Dr Joseph Gurka, Westmead Brain Injury Rehabilitation Service, Australia
  • Dr Adeline Hodgkinson, Liverpool Brain Injury Rehabilitation Service, Australia
  • Dr Clayton King, Brain Injury Unit, Royal Rehabilitation Centre, Sydney, Australia
  • A/Prof Jeno Marosszeky, Department of Rehabilitation Medicine, Westmead Hospital, Australia

    • Purpose
    The use of neurologically active medications following severe traumatic brain injury (TBI) is somewhat controversial. On one hand, there is a small but increasing literature base to support the use of some classes of medications as an adjunct to TBI rehabilitation. Conversely, there is a small amount of data, commonly from animal studies, suggesting that other drug classes may impair recovery.
    There is little, if any, information on the prescribing of neurologically active medications during the early rehabilitation of survivors of severe TBI. This study presents a literature review regarding the pros and cons of these medications and presents descriptive data of the prescribing habits of the three major metropolitan TBI programs in New South Wales, Australia.
    Methods
    Data was obtained from 86 patients previously enrolled in a multi-centre study of post traumatic amnesia (PTA). 77 patients had complete records of all medications used during PTA. Data included drug names, dosage and dates started and stopped. Drugs with neurological activity were classified into ten major groups according to their principal mode of action.
    Results
    Overall, 64 subjects (83%) were treated with one or more psychoactive medication. By classification, the most common medication groups were anticonvulsants (47%), analgesics (27%), benzodiazepines (26%), alpha/beta blockers (23%), antidepressants (22%) and medications with some component of dopamine blockade (18%). The least commonly used medication class was dopamine agonists (6%). Clear differences were evident between the three metropolitan rehabilitation units in terms of prescribing habits.
    Conclusions
    Psychoactive medications were widely used in this patient group with only modest similarity in prescribing habits between units. The potential effects these medication classes have on TBI recovery will be highlighted.

    Conference Organiser - ICMS Pty Ltd