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From the Department of EmergencyMedicine, Traumatology, andRehabilitation, Hartford Hospital, Research Article
Hartford, Connecticut, and theDepartment of Physical Medicine andRehabilitation, Hospital for SpecialCare, New Britain, Connecticut.
Early Polyneuropharmacologic
Data System for MedicalRehabilitation, a division of UB Intervention in Brain Injury Agitation
ABSTRACT
reprints should be addressed toDennis Rosati, MD, Hospital for Rosati DL: Early polyneuropharmacologic intervention in brain injury agitation. Am J Phys Med Rehabil 2002;81:90 –93.
Objective:
To evaluate clinical outcomes observed in the treatment of 0894-9115/02/8102-0090/0American Journal of Physical posttraumatic brain injury agitation with multiple medications.
Medicine & RehabilitationCopyright 2002 by Lippincott Longitudinal evaluation of effect of treatment intervention on patients admitted to a level 1 trauma center with traumatic brain injury.
Eleven adult patients referred for physiatry consultation to manageposttraumatic brain injury agitation were treated with a combination ofmedications and other agents (antipsychotics and sedatives) werediscontinued. The Rancho Los Amigos scale was rated on initialconsultation and follow-up, ranging from 1 to 3 wk.
Results:
All 11 patients demonstrated an average improvement of three Rancho Los Amigos levels within an average treatment durationof 10 days. Simultaneously, 9 of 11 patients were discontinued fromtreatment and prescribed antipsychotic and sedative agents.
Conclusions:
The findings suggest that administration of multiple neuropharmacologic agents used early in the treatment of posttrau-matic brain injury agitation may be an effective therapeutic interventionin which behavioral and, possibly, cognitive benefits occur. These re-sults were noted as patients were discontinued from other agents morecommonly employed in the acute care setting for the treatment ofposttraumatic brain injury agitation. Further research is needed to de-termine the most effective medication combinations and the best timeto initiate treatment.
Key Words:
Am. J. Phys. Med. Rehabil. ● Vol. 81, No. 2 Intervention. Nine of 11 patients
specialists concurred in their ratings.
Setting. The setting was a large 650-
RESULTS AND ANALYSIS
of “early” in describing this interven- Subjects. All 11 subjects were male
Design. A total of 11 patients with
sultation to evaluate and manage PTA.
TABLE 2
Patient data
DOA/DOC, date of admission/date of consult; RLA (I), Ranchos Los Amigos initial level; MEDS PX, medications prescribed; DOF, date of followup; DODC, date of discharge; RLA (D/C), Ranchos Los Amigos followup level; CT, computed tomography;MVA, motor vehicle accident.
aHaldol d/ced.
bAtivan tapered.
tal, five of ten patients had their Ativan DISCUSSION
Am. J. Phys. Med. Rehabil. ● Vol. 81, No. 2 REFERENCES
brain injured patient. Part 1: Definitions, differential diagnosis and assessment.
Arch Phys Med Rehabil 1996;77:617–23 interact to affect rate of recovery after motor cortex surgery. Science 1982;217: and treatment of agitation following trau- Brain Injury Special Interest Group of the and Rehabilitation. Arch Phys Med Reha- ment of acute and chronic behavioral dis- CONCLUSION
orders. Phys Med Rehabil Clin North Am brain injured patient. Part 2: Pathophys-iology and treatment. Arch Phys Med Re- management of traumatic brain injury.
Phys Med Rehabil Clin North Am 1992;3:

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