Evidence map›Paper›PMID 30665668›Full record

SynthesisPsychosomatics

Acute Pharmacological Management of Behavioral and Emotional Dysregulation Following a Traumatic Brain Injury: A Systematic Review of the Literature.

Rebekah P Nash, Marc S Weinberg, Sarah L Laughon, Rebecca Carlson McCall, James R Bateman, Donald L Rosenstein

Open access · greenAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Psychosomatics. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
1.9field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Observational
  4. Article
  5. Article
  6. Review
  7. Traumatic brain injury and mood disorders.The mental health clinician · 2020
    Article
  8. Current Understanding of the Neurobiology of Agitation.The western journal of emergency medicine · 2020
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Rebekah P NashDepartment of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC 27514. Electronic address: rebekah_nash@med.unc.edu.
Marc S WeinbergUniversity of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC 27514.
Sarah L LaughonDepartment of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC 27514.
Rebecca Carlson McCallHealth Sciences Library, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514.
James R BatemanVISN 6 Mental Illness Research, Education, and Clinical Center (MIRECC), Salisbury VA Medical Center, Salisbury, NC 27101; Department of Neurology, Wake Forest University School of Medicine, Winston-Salem, NC 27101.
Donald L RosensteinDepartment of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC 27514.
University of North Carolina at Chapel Hill · USWake Forest University · US

Funding

Fostering Research Mentorship & Training during Psychiatry Residency SupplementR25MH094612 · NIMH · MASSACHUSETTS GENERAL HOSPITAL · PI FAVA, MAURIZIO, GREENFIELD, SHELLY F. · 2011 to 2022
$2.3M
NIMH NIH HHS R25 MH094612
6 · The paper itself

Abstract

backgroundTraumatic brain injury (TBI) is an increasingly common cause of behavioral and emotional dysregulation among hospitalized patients. While consultation-liaison psychiatrists are often called to help manage these behaviors, acute pharmacological management guidelines are limited.

objectiveConduct a systematic review to determine which pharmacological measures are supported by the literature for targeting agitation and aggression in the acute time period following a TBI.

methodsIn a systematic review of MEDLINE, Embase, PsycInfo, ClinicalTrials.gov and the Cochrane Library, we identified and then analyzed publications that investigated the pharmacological management of behavioral and emotional dysregulation following a TBI during the acute time period following injury.

resultsThere were a limited number of high quality studies that met our inclusion criteria, including only five randomized controlled trials. The majority of the literature identified consisted of case reports or case series. Trends identified in the literature reviewed suggested that amantadine, propranolol, and anti-epileptics were the best supported medications to consider. For many medication classes, the time of medication initiation and duration of treatment, relative to the time of injury, may impact the effect observed.

conclusionsThe pharmacological management of agitated patients immediately following a TBI is still an area of much-needed research, as there is limited data-driven guidance in the literature.

Indexed as

Emotional RegulationAcute DiseaseAdrenergic beta-AntagonistsAggressionAmantadineAnticonvulsantsBrain Injuries, TraumaticDopamine AgentsHumansPractice Guidelines as TopicProblem BehaviorPropranololAdrenergic beta-AntagonistsAmantadineAnticonvulsantsDopamine AgentsPropranololaggressionagitationbehavioral dysregulationdisinhibitiontraumatic brain injury

Identifiers

PMID30665668
PMCPMC8609889
OpenAlexW2905479200

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.