Pharmacology and Natural Therapies for Postconcussion Syndrome

Despite the high prevalence of traumatic brain injury, and the subsequent occurrence of neuropsychiatric sequelae, our evidence-based treatment strategies are thus far confined to physical therapy and rehabilitation medicine. Further, there are no standardized medication or natural-based recommendations for patients with postconcussion syndrome (PCS). Yet, clinicians are often presented with patients who have PCS seeking relief and who are anxious about their futures. Prescription-based treatment has traditionally been limited to attempts at symptomatic relief, yet at least 20% of PCS patients will have persistent symptoms for more than 6 months, and a subset will face indefinite issues. Thus, clinicians should also be aware of neuroprotective strategies aimed at reducing the risk of prolonged deficits and future dementias as the result of multiple concussive injuries. Treatment of PCS should involve not only symptomatic relief, but also neuroprotective strategies, and both modalities should begin at initial patient encounters. This article reviews the pharmacotherapy aimed at ameliorating specific complaints, as well as the natural, neuroprotective strategies recommended for long-term use.