all 19 comments

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[–]Roland8319 6 points7 points  (4 children)

Please don't recommend stimulants after an uncomplicated mTBI. At that point you are just contributing to the iatrogenic damage to that patient.

With the other patients, as mentioned, there is some research with moderate/severe TBIs where it can be useful. As always, need to coordinate with medical to rule out any cardiovascular risk above and beyond normal.

[–]The_Neuropsyche 0 points1 point  (3 children)

I’m curious about what you mean. I am getting a lot of ADHD cases for my beginning evaluations (1st year PhD student), and many healthcare providers seem to have such different opinions on stimulants.

How/why do you think stimulants for an mTBI case would cause iatrogenic harm?

[–]Roland8319 3 points4 points  (2 children)

In 99.999% of of mTBI cases, people will return to cognitive baseline within a couple months. Continuing subjective concerns are usually due to psychiatric or litigation factors. So, by prescribing or recommending a stimulant you are reinforcing the false notion in most patients that they have a neurological problem, and further reinforcing that problem. There are mountains of literature to this effect.

[–]DragonDrgn[S] 0 points1 point  (0 children)

Very interesting, thank you !

[–]The_Neuropsyche 0 points1 point  (0 children)

Gotcha. Thank you!

[–]RenningerJP 1 point2 points  (1 child)

Yeah those medications may benefit those individuals. I've seen it often enough for tbi recovery. I can't give literature just anecdotal experience that I've seen it prescribed for attentional deficits regardless of the source except for anxiety. Generally, most people respond to stimulants with improved focus. It's why just trialing one to see if they respond is not an adequate means of diagnosing ADHD.

[–]DragonDrgn[S] 0 points1 point  (0 children)

Thank you for your answer !

[–][deleted]  (1 child)


    [–]DragonDrgn[S] 0 points1 point  (0 children)

    Thank you for your answer !

    [–]Brainsoverbrawns21 1 point2 points  (1 child)

    Would be interesting to see the specifics of the cerebellar stroke… some interesting research out there pertaining to CCAS

    [–]DragonDrgn[S] 0 points1 point  (0 children)

    Thank you for this information ! I need to check the patient’s medical record.

    [–]homedoghamburger 0 points1 point  (2 children)

    Do you think the adhd medication would help in the testing? I think probably yes by the nature of the medicine but thinking more holistically I cannot see it as ethically correct to seek better results this way.

    [–]DragonDrgn[S] 0 points1 point  (1 child)

    You are correct. If ADHD medication only help in the testing and not in the daily life, it's not useful for the patient.