Pharmacological management of neurobehavioural sequelae of traumatic brain injury: A survey of current physiatric practice

Objective: To describe pharmacological preference for the treatment of neurobehavioural sequela of traumatic brain injury (TBI). Design: Survey. Participants: TBI physiatrists were divided into specialists ( completed a TBI fellowship or commit > 70% of clinical practice time to TBI) and non-specialists. Outcome measures: Participants were asked to list the drugs most frequently prescribed for each of 15 neurobehavioural symptoms commonly encountered during TBI rehabilitation and enumerate neurobehavioural symptom for which they prescribed each listed drug or drug class. Results: There was no clear consensus on drug of choice for each target symptom. There were differences in drug choice patterns between specialists and non-specialists, especially for agitation. Conclusion: There is limited uniformity in drug selection for various TBI neurobehavioural sequela. Potential explanations include the availability of various medications with similar clinical effect, the variability of clinical presentation and severity of neurobehavioural symptoms and the lack of clinical practice guidelines.