Long-term treatment with methylphenidate for fatigue after traumatic brain injury

Acta Neurol Scand. 2017 Jan;135(1):100-107. doi: 10.1111/ane.12587. Epub 2016 Mar 15.

Abstract

Objectives: Traumatic brain injury (TBI) may cause long-lasting post-concussive symptoms, such as mental fatigue and concentration difficulties, and this may become the main hindrance for returning to work and studies. There is currently no effective treatment for long-lasting mental fatigue. In this hypothesis generating study, the long-term effects of methylphenidate on mental fatigue, cognitive function, and safety were assessed.

Materials & methods: Thirty participants who suffered from long-term post-concussion symptoms after a mild TBI or moderate TBI and who had reported positive effects with methylphenidate during an initial phase of this follow-up study were treated with methylphenidate for a further six months.

Results: After six-month follow-up, effects on Mental Fatigue Scale (MFS), depression, anxiety, and cognitive function (processing speed, attention, working memory) were significantly improved compared to baseline data (P < 0.001, respectively). Heart rate was significantly increased (P = 0.01), while blood pressure was not changed.

Conclusions: Individuals suffering from prolonged symptoms after TBI reported reduced mental fatigue and improved cognitive functions with long-term methylphenidate treatment. It is suggested that methylphenidate can be a treatment option for long-term mental fatigue and cognitive impairment after a TBI, but further randomized control research is warranted.

Keywords: cognition; mental fatigue; methylphenidate; traumatic brain injury.

Publication types

  • Clinical Trial, Phase II

MeSH terms

  • Adult
  • Attention
  • Brain Injuries, Traumatic / complications
  • Brain Injuries, Traumatic / drug therapy*
  • Central Nervous System Stimulants / adverse effects
  • Central Nervous System Stimulants / therapeutic use*
  • Cognition
  • Female
  • Humans
  • Male
  • Memory, Short-Term
  • Mental Fatigue / drug therapy*
  • Mental Fatigue / etiology
  • Methylphenidate / adverse effects
  • Methylphenidate / therapeutic use*
  • Middle Aged
  • Post-Concussion Syndrome / drug therapy*
  • Post-Concussion Syndrome / etiology

Substances

  • Central Nervous System Stimulants
  • Methylphenidate