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Amitriptyline for post-traumatic agitation.

W J Mysiw1, R D Jackson, J D Corrigan

  • 1Department of Physical Medicine, Ohio State University, Columbus.

American Journal of Physical Medicine & Rehabilitation
|February 1, 1988
PubMed
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Amitriptyline effectively reduced agitation in patients with recent severe brain injuries during inpatient rehabilitation. This treatment aided cognitive recovery without impedance, showing promise for managing post-traumatic agitation.

Area of Science:

  • Neuroscience
  • Psychiatry
  • Rehabilitation Medicine

Background:

  • Agitated behavior affects up to 30% of patients recovering from traumatic brain injury (TBI).
  • Previous treatments included behavioral management and tranquilizers.
  • Agitation can significantly impede rehabilitation progress.

Purpose of the Study:

  • To evaluate the efficacy of amitriptyline in controlling agitation in patients with recent severe TBI.
  • To assess the impact of amitriptyline on cognitive recovery during post-traumatic amnesia (PTA).

Main Methods:

  • A cohort of 58 patients with recent severe TBI undergoing inpatient rehabilitation was studied.
  • Amitriptyline was administered to 20 patients whose agitation persisted despite structured programming.

Related Experiment Videos

  • Agitation frequency, severity, and cognitive performance were monitored using the Orientation Group Monitoring System.

    • Main Results:

    • Within 7 days, 12 of 17 patients in PTA showed a dramatic decrease in agitation after initiating amitriptyline.
    • Response rates varied by cognitive functioning level, with higher effectiveness in less severe cognitive impairment (Rancho Levels IV-VI).
    • Amitriptyline-responsive patients maintained cognitive recovery without impedance.

    Conclusions:

    • Amitriptyline is a useful adjunct for treating nondirected agitation in TBI patients.
    • It can reduce the severity of directed agitation during PTA.
    • Amitriptyline appears to support cognitive rehabilitation without hindering recovery.