Sections
Psychopharmacology: Introduction | Neurotransmitter Disturbances After TBI | Pretreatment Evaluation | Common Patient Concerns Regarding Pharmacotherapy | General Principles | Pharmacological Treatment of Specific Neuropsychiatric Syndromes | Conclusion | Key Clinical Points | Recommended Readings | References
Excerpt
Many useful therapeutic approaches are available
for those who have experienced brain injury. As has been
found with the treatment of psychiatric disorders such as depression,
panic disorder, and obsessive-compulsive disorder, a combination
of therapeutic interventions administered simultaneously often provides
more effective treatment than using a single modality. Individual,
cognitive, behavioral, and family therapy, as well as environmental
manipulation, all may affect symptoms and the patient's
ability to cope with them and are essential elements of any treatment
plan for persons with neuropsychiatric disturbances after traumatic
brain injury (TBI) (see Chapters 31, 36, 37, 38, and 39). For many
patients, pharmacotherapy may be required to provide relief from
such symptoms and to facilitate their ability to benefit maximally
from nonpharmacological interventions. In this chapter, we first
consider neurochemical disturbances produced by TBI in order to frame
the review of pharmacological interventions for posttraumatic neuropsychiatric
disturbances. Next, the general principles of psychopharmacological
management are reviewed. Finally, we describe briefly the medication
options for the treatment of the most common neuropsychiatric sequelae
of TBI and offer practical guidance for their use in everyday clinical
practice. A more detailed description of the role of pharmacotherapy
in the treatment of specific neuropsychiatric symptoms or syndromes
following TBI is presented in chapters on those subjects elsewhere
in this volume.