Tani Jowy, Wen Ya-Ting, Hu Chaur-Jong, Sung Jia-Ying
Department of Neurology, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan.
Sleep Medicine Center, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan.
Pharmaceuticals (Basel). 2022 Jul 6;15(7):838. doi: 10.3390/ph15070838.
The present article reviewed the pharmacologic therapies of traumatic brain injury (TBI), including current and potential treatments. Pharmacologic therapies are an essential part of TBI care, and several agents have well-established effects in TBI care. In the acute phase, tranexamic acid, antiepileptics, hyperosmolar agents, and anesthetics are the mainstay of pharmacotherapy, which have proven efficacies. In the post-acute phase, SSRIs, SNRIs, antipsychotics, zolpidem and amantadine, as well as other drugs, have been used to manage neuropsychological problems, while muscle relaxants and botulinum toxin have been used to manage spasticity. In addition, increasing numbers of pre-clinical and clinical studies of pharmaceutical agents, including potential neuroprotective nutrients and natural therapies, are being carried out. In the present article, we classify the treatments into established and potential agents based on the level of clinical evidence and standard of practice. It is expected that many of the potential medicines under investigation will eventually be accepted as standard practice in the care of TBI patients.
本文综述了创伤性脑损伤(TBI)的药物治疗方法,包括当前的治疗方法和潜在的治疗方法。药物治疗是TBI治疗的重要组成部分,几种药物在TBI治疗中具有公认的疗效。在急性期,氨甲环酸、抗癫痫药、高渗药物和麻醉剂是药物治疗的主要手段,已证实具有疗效。在急性后期,选择性5-羟色胺再摄取抑制剂(SSRI)、5-羟色胺-去甲肾上腺素再摄取抑制剂(SNRI)、抗精神病药、唑吡坦和金刚烷胺以及其他药物已被用于治疗神经心理问题,而肌肉松弛剂和肉毒杆菌毒素已被用于治疗痉挛。此外,越来越多关于药物制剂的临床前和临床研究正在开展,包括潜在的神经保护营养素和自然疗法。在本文中,我们根据临床证据水平和实践标准将治疗方法分为已确立的药物和潜在的药物。预计许多正在研究的潜在药物最终将被接受为TBI患者护理的标准做法。