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Related Concept Videos

Traumatic Brain Injury l: Introduction01:28

Traumatic Brain Injury l: Introduction

DefinitionTraumatic brain injury, or TBI, is a disturbance of normal brain function induced by an external mechanical force, such as a direct blow to the head or a penetrating injury. It can affect both brain structure and function, producing a wide range of clinical outcomes. TBI is a heterogeneous condition, meaning its effects may differ based on the type, location, and severity of the injury.Basis of ClassificationTBI is classified based on severity, injury mechanism, or pathophysiology. In...

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Assessing Dominant-Submissive Behavior in Adult Rats Following Traumatic Brain Injury
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Buspirone for Irritability and Aggression in Chronic Traumatic Brain Injury: A 91-Day Flexible-Dose, Parallel Group,

Flora M Hammond1, James F Malec, Rebecca Runkel

  • 1Author Affiliations: Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis, Indiana (Dr Hammond, Dr Malec, Ms Runkel, and Dr Waltzman); Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota (Dr Malec); and Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, Indiana (Ms Tang and Dr Ren).

The Journal of Head Trauma Rehabilitation
|May 8, 2026
PubMed
Summary

Buspirone did not effectively reduce irritability or aggression in chronic traumatic brain injury (TBI) patients. High placebo response rates in this TBI study suggest environmental factors significantly impact outcomes.

Keywords:
aggressionagitationbrain injuriesbuspironeirritability

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Clinical Trials

Background:

  • Traumatic brain injury (TBI) can lead to chronic irritability and aggression.
  • Effective pharmacological treatments for these post-TBI behavioral symptoms are limited.
  • Buspirone is an anxiolytic medication sometimes considered for behavioral disturbances.

Purpose of the Study:

  • To evaluate the efficacy of buspirone in reducing irritability and aggression in individuals with chronic TBI.
  • To assess outcomes based on self-reports, observer ratings, and clinician assessments.

Main Methods:

  • A randomized, double-blind, placebo-controlled trial involving 81 participants with moderate-to-severe irritability post-TBI.
  • Participants received either buspirone (up to 60 mg/day) or a placebo for 91 days.
  • Irritability and aggression were measured using the Neuropsychiatric Inventory (NPI) domains (NPI-I, NPI-A) and clinician-rated global improvement.

Main Results:

  • Buspirone did not show significant improvement in irritability or aggression compared to placebo across most measures.
  • A statistically significant difference was observed in participant-rated aggression, favoring buspirone (P = .026).
  • High placebo response rates were noted, with substantial improvements in both groups, potentially masking drug-specific effects.

Conclusions:

  • The study does not support the use of buspirone for treating irritability in chronic TBI at the tested dosage and duration.
  • High placebo response rates indicate that structured environments and monitoring may offer significant benefits.
  • Further research is needed to identify effective treatments for TBI-related behavioral issues.