A speedy recovery: amphetamines and other therapeutics that might impact the recovery from brain injury.

Abstract

PURPOSE OF REVIEW:

Traumatic brain injury is the leading cause of death in young patients and stroke is the leading cause of major disability in elderly patients. Both injuries are often followed by cerebral plasticity changes and increased intracerebral pressure (ICP). Aim of the review is to present current knowledge about amphetamines and other therapeutics concerning the recovery of brain injury based on contemporary findings.

RECENT FINDINGS:

On the one hand beneficial effects for cognitive and physical outcome after brain injury by coupling amphetamine with physical therapy could be demonstrated; on the other hand its efficacy was shown in only two out of 10 clinical trials.

SUMMARY:

Impairment after brain injury is reduced if adequate early treatment is established. On the basis of current findings amphetamine after brain injury cannot be recommended. In patients with an increased ICP the maintenance of an adequate cerebral perfusion pressure is required. In patients with increased ICP under controlled ventilation, the combination of ketamine with, for example, a short-acting benzodiazepine and opioid or methohexital is equally well tolerated. Ketamine decreases ICP without lowering blood pressure and cerebral perfusion pressure. Its neuroprotective property might reduce the exacerbation of brain injury following N-methyl-D-aspartate-receptor activation, neuronal apoptosis and systemic inflammatory responses.

• Authors: Anja Harbeck-Seu, Irene Brunk, Thomas Platz, Peter Vajkoczy, Matthias Endres, Claudia Spies
• Journal: Current opinion in anaesthesiology (Curr Opin Anaesthesiol) Vol. 24 Issue 2 Pg. 144-53 (Apr 2011) ISSN: 1473-6500 [Electronic] United States
• PMID: 21386667 (Publication Type: Journal Article, Review)

Chemical References

• Amphetamines
• Central Nervous System Stimulants

Topics

• Amphetamines (pharmacology, therapeutic use)
• Brain Injuries (drug therapy, psychology, rehabilitation)
• Central Nervous System Stimulants (pharmacology, therapeutic use)
• Craniocerebral Trauma (therapy)
• Emergency Medical Services
• Humans
• Intracranial Hypertension (drug therapy, etiology)
• Patient Transfer
• Randomized Controlled Trials as Topic
• Recovery of Function
• Stroke (drug therapy, psychology)
• Stroke Rehabilitation