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Updated: Jul 10, 2025

SECONDs Administration Guidelines: A Fast Tool to Assess Consciousness in Brain-injured Patients
Published on: February 6, 2021
Pharmacology in Treatment of Patients with Disorders of Consciousness
1Moss Rehab, 60 Township Line Road, Elkins Park, PA 19027, USA; Remed Residential Brain Injury Center.
Abstract:
Pharmacologic treatment of disorders of consciousness remains a critical but challenging task for clinicians. Amantadine has been shown to promote the rate of neurologic recovery for patients with traumatic disorders of consciousness when administered between 4 and 16 weeks, as demonstrated by a well-designed randomized control trial. While there are no large, randomized controlled trials to support the use of other dopaminergic medicines (bromocriptine, levodopa, apomorphine), there is a large body of literature implicating their role in improving alertness and responsiveness in disorders of consciousness. Zolpidem can increase the level of consciousness in a small subset of patients. Zolpidem and intrathecal baclofen likely increase the level of consciousness via the mesocircuit pathway. Psychostimulant medications can be initiated in patients, even without strong evidence to support their use, as long as basic principles of brain injury medicine are followed, and there are systems in place to evaluate therapeutic response.
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