Psychotropic-absent behavioural improvement following severe traumatic brain injury

We present a case study in which severe agitation was reduced and independent functioning increased in a traumatically brain-injured individual. The subject's behaviour for the year prior to admission was characterized by increasing rates of maladaptive behaviours and corresponding increases in pharmacological attempts at behaviour management. Upon admission, the subject was totally dependent on others for all activities of daily living. A data-based systematic withdrawal of a number of psychotropic medications and the addition of an anticonvulsant medication was conducted in an AB experimental design. Reductions of medications in conjunction with behavioural interventions resulted in immediate reduction in rate of maladaptive behaviours. Further reductions in psychotropic medications and the addition of the anticonvulsant medication resulted in continued rapid deceleration of rate of occurrence of maladaptive behaviours with a concomitant increase in lucid statements and independent functioning. A follow-up conducted at 6 months showed the subject to be independent in performance of activities of daily living in a semi-independent living situation, with maladaptive behaviours continuing to be well managed.