Newswise — Atlanta – A new study presented this week at the Association of Academic Physiatrists’ Annual Meeting in Atlanta found that medications commonly prescribed to people after a concussion to reduce their symptoms may not do much to affect their recovery. Sports medicine physicians commonly treat patients with concussion, so researchers in Utah investigated how some widely prescribed treatments might affect patients’ recovery.
“We really don’t have much other than rest and gentle exercise to combat symptoms of concussion,” says Venessa Lee, MD, a resident in physical medicine and rehabilitation at University of Utah Health in Salt Lake City and presenting author of the study. “Medications are commonly prescribed to help with symptoms, but there is very little evidence that they help more than just time and rest.”
While there is currently no medication approved by the U.S. Food and Drug Administration (FDA) to treat concussion, physicians may prescribe medications like gabapentin or tricyclic antidepressants (called TCAs) to help reduce symptoms during recovery. Do these drugs do patients any good? To find out, Dr. Lee and her research team looked back at 277 patients who had been diagnosed with concussion at a local academic sports medicine practice. At each of their visits to the clinic during recovery, patients reported their post-concussion symptoms. The research team used a score sheet to measure their symptoms, and they tracked scores of patients who had more than one visit to the clinic up to one year later.
Patients were divided into three groups for the study: those not prescribed any medication, those prescribed gabapentin, and those prescribed one of two TCAs, amitriptyline or nortriptyline. Based on self-reported information, they gave each patient a score for two important factors of post-concussion recovery: headaches and a combination of 22 symptoms, including headaches. Each score was on a scale of zero to six.
After they adjusted scores for gender and age, Dr. Lee’s team found that both headache and combined symptoms scores went down significantly within days after the first clinic visit for all three groups of patients – those who had taken no medications, those who had been prescribed gabapentin, and those who had been prescribed a TCA. Patients who had been prescribed any of the medications did have significantly higher scores for headaches and overall post-concussion symptoms to begin with, but no one type of medication had any better or worse effect over the duration of the study, the study showed.
“Patients’ symptoms improve with time after a concussion,” Dr. Lee explains of the study’s findings. “When we looked at gabapentin and TCAs, their symptoms improved over time as well, but similar to those that didn’t receive a medication,” she notes.
Based on this study, neither gabapentin nor TCAs appear to have any additional benefit for post-concussion recovery. With this information, patients may be able to avoid taking unnecessary medications as they recover from concussions. Dr. Lee suggests patients should speak with a physician about their symptoms after a concussion.
While this study has eye-opening conclusions, Dr. Lee notes the study has its limitations and more work should be done in this area. “Though the two medications we studied did not show a profound improvement in our analysis, this was a retrospective study (where we look back in time), which has many drawbacks and limitations,” says Dr. Lee. “We need to do more research to really find the best method for improving post-concussive symptoms.”
The Association of Academic Physiatrists (AAP) is the only academic association dedicated to the specialty of physiatry. The AAP is an organization of leading physicians, researchers, in-training physiatrists, and others involved or interested in mentorship, leadership, and discovery in physiatry. The AAP holds an Annual Meeting, produces a leading medical journal in rehabilitation, AJPM&R, and leads a variety of programs and activities that support and enhance academic physiatry. To learn more about the Association and field of physiatry, visit physiatry.org and follow us on Twitter using @AAPhysiatrists. To learn more about the AAP's 2018 Annual Meeting, visit physiatry.org/2018.