Care must be taken in prescribing medications for patients with TBI, as they may be overly sensitive to medications and side effects may be more pronounced, due to changes in the blood-brain barrier that may occur as a result of TBI.

Self-medicating should be discouraged. Over-the-counter medications and herbal remedies should be cleared with the patient’s physician, as some of these medications may be harmful for the patient with TBI, or may react adversely with medications the patient is already taken and that has been prescribed.

The following are some of the common medication categories from which medications may be prescribed by the patient’s physician following TBI:

• Anti-Convulsants- these drugs may be used in the acute phase of TBI, following surgery for TBI to prevent seizures, or long term to prevent seizures. They may also be used to promote sleep and to treat various psychological disorders, such as bipolar and panic disorders. Weight gain is a common and sometimes undesirable side effect.
• Antidepressants- these drugs are used to treat various psychological disorders, such as depression, anxiety, obsessive-compulsive disorder (OCD), and panic disorders. Antidepressants are also sometimes used to treat chronic pain syndromes and migraine headaches. They may have several side effects that patients find intolerable; if this occurs, another antidepressant from a different family of antidepressants may be tried.
• Anti-psychotics-these medications are used in patients who exhibit aggressive or agitated behaviour. They may be used to treat schizophrenia, sleep disorders, and psychotic disorders. These drugs may also cause weight gain.
• Narcotics- narcotics are strong painkillers given to relieve severe pain, and may be used to treat many different types of pain. Narcotics may be habit-forming if taken for an extended period of time. The patient may also build up a tolerance to the drug, so that larger doses of the drug are needed to achieve the same benefit.
• Other Pain Relievers-milder pain relievers, such as acetaminophen (Tylenol), ASA (aspirin), and Ibuprofen (Motrin, Advil) may be used to treat less severe pain experienced by patients with TBI. Ibuprofen and ASA can cause bleeding and may not be recommended for patients with certain types of TBI.
• Muscle Relaxants-Drugs in this category may be used to relieve muscle pain and spasm. They may have some undesirable side effects, such as fatigue.