medications for traumatic brain injury

[promethius]

I am taking care of a patient with a brain injury as an outpatient who has been taking ritalin and a SSRI prescribed by a previous physiatrist. I have used stimulants before for treatment of patients with arousal or concentration issues following brain injuries, but what about the use of SSRIs? Do they help with neuronal remodeling and neuroprotection following central nervous system injuries? I guess it would probably depend on the symptoms and response to those two medications, but how long would you keep a brain injury patient on these two medications before you consider starting to taper the patient off of them?

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[PMR2008]

SSRI are ideal if there is concurrent depression. I would not recommend long term just for neuroprotection. If anything there is controversy using SSRI's even after a CVA (FLAME vs Focus trial). I tend to not use stimulants for too long but as long as it is helping with concentration/function I am okay with continuing long term.