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Drug Information Specialist, College of Pharmacy, Xavier University, New Orleans, LA; Drug Information Center at Tulane University Hospital and Clinic, 1415 Tulane Ave., Box HC-12, New Orleans, LA 70112-2632, fax 504/588-5862, osiddall{at}tulane.edu
Reprints: Dr. Siddall
OBJECTIVE: To review literature regarding the effectiveness of methylphenidate in the management of the cognitive and behavioral changes observed following traumatic brain injury (TBI).
DATA SOURCES: A literature search was conducted using the following databases: MEDLINE (1966–June 2004); Cochrane Central Register of Controlled Trials, fourth quarter 2004 (1988–June 2004); and International Pharmaceutical Abstracts (1970–June 2004). Methylphenidate and brain injury were the key search terms used. Limits were set to include clinical trial publications, human subjects, and English language.
DATA SYNTHESIS: Ten clinical trials evaluating the efficacy and safety of methylphenidate in pediatric and adult patients with TBI are reviewed. Improvements in different aspects of cognition and behavior were evaluated before, during, and after treatment with methylphenidate. The results demonstrated that methylphenidate is likely to improve memory, attention, concentration, and mental processing, but its effects on behavior have not been determined.
CONCLUSIONS: Larger, double-blind, placebo-controlled studies are needed to determine optimal doses, during which phase of recovery to begin treatment, length of treatment, and long-term effects for patients with mild, moderate, and severe TBI.
Key Words: methylphenidate, traumatic brain injury
Published Online, May 24, 2005. www.theannals.com, DOI 10.1345/aph.1E637
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