Semin Neurol 2022; 42(03): 335-347
DOI: 10.1055/s-0042-1755271
Review Article

Pharmacologic Therapies to Promote Recovery of Consciousness

Megan E. Barra
1   Department of Pharmacy, Massachusetts General Hospital, Boston, Massachusetts
2   Department of Neurology, Center for Neurotechnology and Neurorecovery (CNTR), Massachusetts General Hospital, Boston, Massachusetts
,
Brian L. Edlow
2   Department of Neurology, Center for Neurotechnology and Neurorecovery (CNTR), Massachusetts General Hospital, Boston, Massachusetts
3   Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts
,
Gretchen M. Brophy
4   Department of Pharmacotherapy and Outcomes Science and Neurosurgery, Virginia Commonwealth University, Medical College of Virginia, Richmond, Virginia
› Author Affiliations
Funding B.L.E. reports support from the National Institute of Neurological Disorders and Stroke, National Institutes of Health (R21NS109627), and Tiny Blue Dot Foundation. B.L.E. and M.E.B. report support from the National Institutes of Health Director's Office (DP2HD101400) and James S. McDonnell Foundation. This work was completed at the time M.E.B. was employed with Massachusetts General Hospital; M.E.B. is now an employee of Marinus Pharmaceuticals.

Abstract

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.



Publication History

Article published online:
13 September 2022

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