Prescribing of potentially harmful drugs to patients admitted to hospital after head injury.

Fundamental studies in laboratory animals show that certain drugs influence behavioural recovery after brain injury. Although some drugs have the potential to enhance recovery, others may be detrimental. The purpose of the present study was to determine how often these potentially detrimental drugs are used in the management of patients with traumatic brain injury. The medical records of 100 patients with head trauma admitted to a university hospital during one year were reviewed and the frequencies of medication prescriptions during the stay in hospital were recorded. Only 14% of patients with head injury were taking medications at the time of injury. All of the patients were prescribed medications during their stay in hospital. Seventy two per cent of the patients received one or a combination of the drugs (neuroleptics and other central dopamine receptor antagonists, benzodiazepines, and the anticonvulsants phenytoin and phenobarbitone) that animal studies suggest may impair recovery. Until the true impact of these classes of drugs on the recovery process is better understood, care should be exercised in their use.