Use of stimulants seemed to improve attention after first-time administration and for short time periods in individuals with traumatic brain injury (TBI), data from a systematic review published in the Annals of Clinical Psychiatry has found.

Researchers from MetroHealth, Cleveland, OH, conducted a literature search of major databases to identify randomized controlled trials on the use of stimulants for patients diagnosed with TBI. The search returned 176 total articles, of which 18 met the inclusion criteria for the review. Seventeen of the 18 studies evaluated methylphenidate, one evaluated dextroamphetamine and methylphenidate, and one evaluated modafinil

A significant improvement in depressive symptoms with methylphenidate was seen in one study. Seven studies demonstrated significant improvement in reaction time where as four studies demonstrated significant improvement in accuracy with methylphenidate vs. placebo. One of the two studies that included follow-up found significant differences in disability ratings, attention-concentration, and motor memory at 30 days between the stimulant and placebo cohorts.

The majority of the studies showed significant treatment effects within minutes to hours after first-time administration of stimulants. Five studies however, did not show benefit for stimulants vs. placebo. In addition, two studies that evaluated self-reported side effects found no significant difference between treatment groups but one study showed a significant increase in mean arterial pressure in the stimulant group. 

In general, study authors found limited evidence to suggest efficacy of stimulant medication for psychiatric symptoms in patients with TBI but its use improved attention with first-time administration. 

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