Research Article
Volume 12 Issue 1 - 2020
Stimulant Use to Improve Wakefulness Following Brain Injury: A Survey of the Neurocritical Care Society
James Peoples1,2,3*, Alejandro J Lopez1, Kristofer Feeko5, Lauren Ng2,3, Michelle Gobrial2,3, Omar Shah2,3, Matthew Vibbert2,3, Jacqueline Urtecho2,3, Jack Jallo3, Rodney Bell2,3, Fred Rincon2,3, Barak Bar2,3 and M Kamran Athar3,4
1Department of Neurocritical Care, Tower Health Reading Hospital, Reading, PA, USA
2Departments of Neurology, Thomas Jefferson University, Philadelphia, PA, USA
3Departments of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, USA
4Departments of Medicine, Thomas Jefferson University, Philadelphia, PA, USA
5Departments of Physical Medicine and Rehabilitation, Thomas Jefferson University, Philadelphia, PA, USA
*Corresponding Author: James Peoples, Department of Neurocritical Care, Tower Health Reading Hospital, West Reading, PA, USA.
Received: November 20, 2019; Published: December 04, 2019


Background: Brain injury can have lasting neurologic sequelae. Many patients suffer from disorders of attention and arousal following severe brain injury. A majority of the therapies we offer these patients are largely supportive. Our goal was to create and distribute a clinical practice survey to evaluate which specific medications are currently being used by neurointensivists in the management of attention and arousal disorders following brain injury.

Methods: An 8 question unvalidated survey was organized and distributed to the 1366 members of the Neurocritical Care Society (NCS), made up of neurointensivists, medical intensivists, neurosurgeons and anesthesiologists. The survey was conducted from November 15, 2013 through November 29, 2013.

Results: 122 responses were obtained. More than half of respondents were neurointensivists (54.9%). 59.8% of the respondents selected amantadine as their medication of choice to address attention and arousal issues. 69.4% of the respondents initiated therapy more than a week out from injury. 34.4% of the respondents treat their patients for more than 2 weeks. 55.7% of respondents reported trying another agent, if the initial selection did not improve wakefulness. 76.2% selected traumatic brain injury (TBI) as the primary diagnosis of patients receiving pharmacologic treatment. Overall, 50.4% of the respondents felt that medications were effective only a quarter of the time. Only a single respondent reported an institutional protocol for administering stimulants for wakefulness.

Conclusion: Amantadine is used most frequently; however, the medications and time schedules that are utilized vary. Only one respondent reported an institutional policy that directs therapy.

Keywords: Amantadine; Stimulants; Brain Injury; Disorders of Attention and Arousal


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Citation: James Peoples., et al. “Stimulant Use to Improve Wakefulness Following Brain Injury: A Survey of the Neurocritical Care Society”. EC Neurology 12.1 (2020): 01-06.

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