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Critical Reviews™ in Physical and Rehabilitation Medicine
SJR: 0.121 SNIP: 0.228 CiteScore™: 0.17

ISSN Print: 0896-2960
ISSN Online: 2162-6553

Critical Reviews™ in Physical and Rehabilitation Medicine

DOI: 10.1615/CritRevPhysRehabilMed.v21.i3-4.20
pages 215-229

Management of Traumatic Brain Injury-Related Agitation

Michal E. Eisenberg
Rusk Institute of Rehabilitation Medicine, New York University School of Medicine, USA
Brian Im
Brain Injury Rehabilitation, Bellevue Hospital Center, Rehabilitation Medicine, New York University School of Medicine, USA
Patrick Swift
Neurology and Rehabilitation Medicine, Rusk Institute of Rehabilitation Medicine, New York University School of Medicine, USA
Steven R. Flanagan
Department of Rehabilitation Medicine, Rusk Institute of Rehabilitation Medicine, New York University School of Medicine, USA

ABSTRACT

Agitation following traumatic brain injury (TBI) is a common problem that significantly interferes with the rehabilitation process and frequently prevents injured persons from successfully returning to their desired societal roles and communities. There are no standards of care regarding the management of TBI-related agitation due to the lack of a widely accepted definition of the problem, as well as to the paucity of well-designed and adequately powered trials examining treatment interventions. Given the lack of a standard of care, clinicians are advised to address agitation using an interdisciplinary approach involving health care professionals and family members that consists of environmental and behavioral modifications and, when necessary, the judicious use of medications. Medication choice is challenging because of the unique TBI-related problems of poor arousal and cognitive impairments that are often exacerbated by commonly used psychotropic drugs. Physicians must choose medications that promote participation in rehabilitation and reduce maladaptive behavior without sedating or cognitively impairing effects that adversely impact recovery.


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