Medications for Postconcussive Syndrome/TBI agitation/psychosis

[nexus73]

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Can someone point me towards a reference for treating agitation/psychosis after TBI? Rarely see this but hoping to find an evidence base for which meds to use or not use. Basics I've found so far include avoiding haldol and benzos. Most articles say there isn't much research to back treatment approaches.

 

[forchinet121]

I’ve had decent experience with Seroquel and Thorazine

 

[shoomer]

Beta blockers have some data for agitation in TBIs.

 

[PsyDr]

1) With all intended kindness: You would be well served to look up the correct spelling for PCS, and diagnostic criteria for it. That one misunderstanding is likely complicating your literature search.

2) Amantadine has some evidence base in post TBI agitation, although there is some debate.


Hammond, F. M., et al. (2014). "Effectiveness of Amantadine Hydrochloride in the Reduction of Chronic Traumatic Brain Injury Irritability and Aggression." The Journal of head trauma rehabilitation 29(5): 391-399.

 

[claypigeon]

I use this as a reference and like it. I’ve not found metoprolol to work near as well as propranolol but that’s my only critique

https://medicine.uams.edu/pmr/wp-content/uploads/sites/3/2020/09/Guidelines-TBI-Agitation-2020.pdf

 

[medium rare]

I use this as a reference and like it. I’ve not found metoprolol to work near as well as propranolol but that’s my only critique

https://medicine.uams.edu/pmr/wp-content/uploads/sites/3/2020/09/Guidelines-TBI-Agitation-2020.pdf

Great resource. I’ve observed favorable responses from propranolol, amantadine, quetiapine and buspirone (not in combination, typically). Buspirone primarily as an anxiolytic.