A retrospective analysis conducted at University of Utah Health has concluded that commonly prescribed medications for concussion sufferers have little positive impact on severity of symptoms, or the course of recovery. Presenting author Venessa Lee, MD, resident in physical medicine and rehabilitation at University of Utah Health, commented, “We really don’t have much other than rest and gentle exercise to combat symptoms of concussion. Medications are commonly prescribed to help with symptoms, but there is very little evidence that they help more than just time and rest.” To date, the FDA has not approved any medication specifically for treatment of concussion, but patients are frequently prescribed either gabapentin or a tricyclic antidepressant (TCA) such as amitriptyline or nortriptyline. Dr. Lee sought to investigate the efficacy of these medications in her team’s study, the results of which were presented last week at the annual meeting of the Association of Academic Physiatrists in Atlanta.
The study examined data from 277 patients diagnosed with concussion at a local sports medicine practice. Patients were sorted into those who took no medication, those who received gabapentin, and those who received either of the 2 TCAs. Members of each cohort were scored on 2 elements of postconcussion recovery: headache and a combination of 22 symptoms that included headache. Over the course of successive clinic visits, scores for both headache and combined symptoms declined in equal measure for members of all 3 groups. This, according to the authors, suggests that time, rather than medications, is the significant contributor to concussion recovery, and that the addition of medication to the treatment protocol may have little incremental benefit. Dr. Lee noted the drawbacks of the retrospective analysis, however, and stated that further research is needed.
Read a news story about the study findings.
Posted on February 19, 2018