Pharmacological management for agitation and aggression in people with acquired brain injury

Fleminger, Simon; Greenwood, R; Oliver, DL

doi:10.1002/14651858.cd003299

Cited by 55 publications

(57 citation statements)

References 78 publications

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“…Beta-blockers were shown to decrease the intensity of agitated episodes and the frequency of assault attempts in four randomized controlled trials with subjects with TBI identified in a recent Cochrane review [106][107][108][109][110]. All trials were small in sample size (up to 21 subjects).…”

Section: Beta-blockersmentioning

confidence: 99%

Pharmacological management of neurobehavioral disorders following traumatic brain injuryA state-of the-art review

Chew

Zafonte²

2009

JRRD

159

103

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Abstract-Pharmacological management of neurobehavioral disorders following traumatic brain injury (TBI) is common practice. However, the evidence available to guide this practice remains sparse. This review summarizes, in brief, the state of knowledge, organized via a time continuum from injury as well as by symptom complex. The areas of neuroprotection, hypoarousal, attention and memory deficits, aggression, agitation, depression, and mania are reviewed. The literature was searched with PubMed on the terms "traumatic brain injury" or "brain injury" with "pharmacology" (and the symptoms according to which this review is arranged). Additional searches were conducted with the specific symptoms as search terms, crossed with the therapeutic agents or drug classes discussed. Where a paucity of prospective data exists, case reports and retrospective studies are included. Studies to date have yielded minimal positive evidence for enhancing function, memory, and behavior after TBI. No single agent likely will become sentinel in the recovery process, and combination therapy in the acute and postacute settings are required. A need exists to further define the role of psychopharmacology in postacute TBI medicine and the specific characteristics of subpopulations who might benefit.

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Section: Beta-blockersmentioning

confidence: 99%

Pharmacological management of neurobehavioral disorders following traumatic brain injuryA state-of the-art review

Chew

Zafonte²

2009

JRRD

159

103

View full text Add to dashboard Cite

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“…Several randomized trials conducted to establish ideal medication management of the agitated brain injured patient only begin to describe adequate care of this patient population. The more common medications to help control agitation include: antiepileptics, dopamine agonists (amantadine), antidepressants, antipsychotics (haldol), and beta blockers (inderal) [54]. However, little research is available to answer significant nursing questions regarding patient management of the agitated neuroscience patient.…”

Section: Tbi and Agitationmentioning

confidence: 99%

Neurocritical Care Nursing Research Priorities

et al. 2011

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The science of nursing has long been discussed as a blending of the art and science of caring, and nursing research builds the evidence of support for nursing practice. Nurses and nursing care are key to successful neurocritical care research endeavors. Ideally nursing care should be evidence based and supported by solid research. The goal of nursing research is to expand the knowledge of caring for patients. Within the scope of nursing research, the priorities for research in neurocritical care should support this goal. In this manuscript, we discuss what we believe are the priorities of neurocritical care nursing research, the obstacles, and some possible solutions.

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“…If sedation is required for more than one or two days, atypical antipsychotic medication should be used (eg olanzapine or quetiapine) with which there is less chance of producing extrapyramidal side effects. Valproate, carbamazepine and beta-blockers may be helpful 3 . Drug combinations should be avoided as these may increase agitation and aggression by increasing confusion.…”

Section: Management Of Agitationmentioning

confidence: 99%

“…Early agitation predicts long-term aggressive behaviour, which typically is explosive. There is no evidence that aggression differs from agitation in terms of its response to medication 3 .…”

mentioning

confidence: 99%