Department of Pharmacy, Massachusetts General Hospital, Boston, Massachusetts.
Department of Neurology, Center for Neurotechnology and Neurorecovery (CNTR), Massachusetts General Hospital, Boston, Massachusetts.
Semin Neurol. 2022 Jun;42(3):335-347. doi: 10.1055/s-0042-1755271. Epub 2022 Sep 13.
Pharmacologic interventions are commonly used to support rehabilitation efforts of patients with disorders of consciousness (DoC). The 2018 practice guidelines recommend amantadine in adults with traumatic DoC to promote functional recovery, though several other stimulants are used off-label in clinical practice and trials, such as methylphenidate, bromocriptine, levodopa, and zolpidem. Differences in the mechanisms of action, adverse effects, pharmacokinetics, and drug-drug interactions should be considered when selecting the best agent for each individual patient. Overall, pharmacologic stimulants may provide a safe and inexpensive pathway to increased functionality and participation in rehabilitation. This article provides a concise summary of scientific evidence supporting the use of pharmacologic therapies to stimulate recovery of consciousness in patients with DoC.
药物干预通常用于支持意识障碍（DoC）患者的康复努力。2018 年的实践指南建议在创伤性 DoC 的成年人中使用金刚烷胺，以促进功能恢复，尽管其他几种兴奋剂在临床实践和试验中被超适应证使用，如哌甲酯、溴隐亭、左旋多巴和唑吡坦。在为每个个体患者选择最佳药物时，应考虑作用机制、不良反应、药代动力学和药物相互作用的差异。总的来说，药物兴奋剂可能为提高功能和参与康复提供一种安全且廉价的途径。本文简要总结了支持使用药物治疗来刺激 DoC 患者意识恢复的科学证据。
