The Use of Pharmacology in the Treatment of Head-Injured Patients

Abstract

It is common for cognitive, emotional, and behavioral deficits to occur following head injury. However, research reveals that head-injured individuals are more seriously handicapped by emotional and associated behavioral disturbances (e.g., agitation) than by residual cognitive or physical disabilities (Lezak, 1987). These emotional disturbances may impede their overall recovery from the head trauma (Dikeman & Reitan, 1977; Jackson, Corrigan, & Arnett, 1985; Levin, Grossman, Rose, & Teasdale, 1979; Lishman, 1973; Prigatano, 1986; Stern, 1978; Thomsen, 1984). A frequently exhibited problem in up to 33% of patients recovering from significant head-injury is agitation, characterized by cognitive disorganization, interpersonal isolation, combativeness, and affective disturbance (Jackson et al., 1985). Additionally, 67% of patients post-head injury experience anxiety, regressive manifestations, and frontal lobe syndromes (e.g., flattened affect, apathy, loss of inhibitions, disturbance in judgement) (Lishman, 1973; Stern, Najenson, Grosswasser, Mendelson, & Davidson, 1976). Also, emotional and behavioral disturbances are not limited to moderately and severely impaired patients. Patients attaining good cognitive recovery often exhibit significant anxiety and depression as well. It is not uncommon for emotional and behavioral impairments to develop into significant psychiatric disorders of psychotic proportions that can require inpatient treatment.