Written by Dr. Peter Jenkins (Neurology Registrar, Brain Injury researcher who is currently running a trial evaluating methylphenidate in treating cognitive problems after brain injury)
Edited by Lucia M Li
Problems with concentration, memory and speed of thinking are common after traumatic brain injury. There are no licensed drugs to treat these problems although several have been tested. Perhaps the most encouraging one to date is methylphenidate.
What is methylphenidate?
Methylphenidate is a stimulant (like caffeine) and is already commonly used in the treatment of attention deficit hyperactivity disorder (ADHD) in children. It increases certain chemicals in the brain (specifically dopamine and noradrenaline) that are vital for normal brain functioning. It has a good safety record from its use in treating ADHD and is sometimes known by its trade names, including Ritalin and Concerta.
Does it help improve thinking after traumatic brain injury?
Methylphenidate is not licensed for use in the UK for problems with thinking after traumatic brain injury. There are, however, some good reasons why it may benefit certain patients who have suffered a head injury.
Studies in humans and animals suggest that one of the chemicals that methylphenidate increases (namely dopamine) can be reduced after a head injury. As dopamine is needed for normal brain functioning, if levels are reduced, this may cause some of the problems encountered after a head injury. In addition, several trials have examined the use of methylphenidate in patients who have suffered a head injury. In these trials certain brain functions including speed of thinking and concentration appear to be improved although not all trials showed a benefit.
The situation is, however, more complicated than this. Head injuries vary greatly in their severity and what parts of the brain are damaged. Therefore, different people are likely to have differing problems following a head injury. This is important when it comes to increasing chemicals in the brain like dopamine. This is because dopamine levels that are too high are as bad as levels that are too low. For this reason it is likely that methylphenidate may benefit some people but not all.
What is the future for methylphenidate and head injuries?
There are on-going studies investigating whether it is possible to determine which patients will respond to methylphenidate. The aim is to try and identify patients that may benefit from treatment using tests such as brain scans.
Edited by Lucia M Li
Problems with concentration, memory and speed of thinking are common after traumatic brain injury. There are no licensed drugs to treat these problems although several have been tested. Perhaps the most encouraging one to date is methylphenidate.
What is methylphenidate?
Methylphenidate is a stimulant (like caffeine) and is already commonly used in the treatment of attention deficit hyperactivity disorder (ADHD) in children. It increases certain chemicals in the brain (specifically dopamine and noradrenaline) that are vital for normal brain functioning. It has a good safety record from its use in treating ADHD and is sometimes known by its trade names, including Ritalin and Concerta.
Does it help improve thinking after traumatic brain injury?
Methylphenidate is not licensed for use in the UK for problems with thinking after traumatic brain injury. There are, however, some good reasons why it may benefit certain patients who have suffered a head injury.
Studies in humans and animals suggest that one of the chemicals that methylphenidate increases (namely dopamine) can be reduced after a head injury. As dopamine is needed for normal brain functioning, if levels are reduced, this may cause some of the problems encountered after a head injury. In addition, several trials have examined the use of methylphenidate in patients who have suffered a head injury. In these trials certain brain functions including speed of thinking and concentration appear to be improved although not all trials showed a benefit.
The situation is, however, more complicated than this. Head injuries vary greatly in their severity and what parts of the brain are damaged. Therefore, different people are likely to have differing problems following a head injury. This is important when it comes to increasing chemicals in the brain like dopamine. This is because dopamine levels that are too high are as bad as levels that are too low. For this reason it is likely that methylphenidate may benefit some people but not all.
What is the future for methylphenidate and head injuries?
There are on-going studies investigating whether it is possible to determine which patients will respond to methylphenidate. The aim is to try and identify patients that may benefit from treatment using tests such as brain scans.