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Can Ritalin Help Mitigate Brain Injury Symptoms?

Comments [22]

Brian Greenwald, MD, BrainLine

Can Ritalin Help Mitigate Brain Injury Symptoms?
 

My 54-year-old husband sustained a TBI when he fell asleep at the wheel while driving and hit a tree. The doctors say that he damaged all four parts of his brain. It’s been more than one and a half years and he’s still totally dependent on me to take care of him. Do you think Ritalin would help stimulate his brain?

 

Methylphenidate (Ritalin) is one of the commonly used brain stimulants in people who have suffered traumatic brain injury. It increases chemicals in the brain that have a stimulating effect (norepinephrine and dopamine).

After traumatic brain injury, doctors commonly prescribe Ritalin for low arousal or initiation, poor attention and concentration, depression, and slow processing speed. There is research that shows that Ritalin may speed recovery early after moderate to severe TBI. There is also research showing that Ritalin increases mental processing speed after TBI, which can improve memory function in some people.

All medications have side effects and the risks need to be weighed against possible benefits. One of the good things about the standard formulation of Ritalin is that it is short acting so if side effects occur they wear off in a few hours. Some potential side effects include keeping you up at night (if taken too close to bedtime), decreased appetite, headache, irritability, and paranoia.

In your husband’s case, his doctor needs to look at why he is so dependent. If arousal, attention, and/or initiation are playing a significant role, a stimulant can be considered. Careful monitoring for effects and/or side effects is needed when starting this medication and it should only be done by a doctor who has experience in caring for people with traumatic brain injury. Ritalin and most stimulants are controlled substances and will require frequent visits to the doctor for prescriptions.

 

Click here to go to About Ask the Expert.

Brian D. Greenwald, MD Brian D. Greenwald, MD, Dr. Brian Greenwald is medical director of Center for Head Injuries and the associate medical director of JFK Johnson Rehabilitation Institute. He is a clinical associate professor in the Department of Physical Medicine and Rehabilitation at UMDNJ-Robert Wood Johnson Medical School.


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Comments [22]

I suffered a TBI - concussion after a bicycle accident 3 years ago - yes I was wearing a helmet, unfortunately I landed on my jaw and the strap seems to have done irreversible damage to my vocal cords.

As I was going through additional extremely stressful life events at the time, in addition to losing my job as an RN (can't believe how many RNs are on this thread - my heart goes out to you). It took a while for the external stress to reduce to the level where I new that the lack of concentration, poor scanning, and short term memory problems were not going to go away. A brain injury clinic suggested a support group to learn new coping skills to adapt to my "new normal" - this is recent and I haven't done it yet but I do believe it will be helpful based on the OT my brother received after a brain aneurysm many years ago. I tried Adderal given to me a friend this year, and while in some ways it was a shock to discover the function I had lost in a quantifiable way, it also gave me some hope. I am currently on low-dose (10mg XR) ritalin for post-consussive symptoms and I'm hoping to figure out the kinks so I can take this regularly. (I think I might react differently to Brand and Generic versions so I am exploring this right now. My brain injury clinic also recommended a blue light to help with restoring regular sleeping patterns - which I plan to buy as soon as I can afford it. Good luck every one. There's always a silver lining... I've never been able to truly understand how my brother's injury felt, and now I can. This injury has definitely increased my empathy with others with TBI and I'm grateful for that.

Mar 16th, 2017 6:36pm

Check with the TBI Alliance in your state. There are people there to help with any and all questions from counseling to affordable housing because of a disability. Good luck. I know how scary and unsure you must feel. Have faith...

Feb 27th, 2017 9:12pm

I have a TBI from a motorcycle accident that's when my whole life turned upside down. It happened in Raton, NM and I am so grateful that all the people behind us were on their way to a doctor's convention. They cut off my boots and clothes. I was so grateful they had a baby blanket. I was taken flight for life to St. Thomas more but I don't think they knew how to treat me after being brought back I was very combative I stayed their aprox 27 days then transported to Craig hospital in Denver and put in a bed that was enclosed and locked. It was very hard for my children to talk to me and to know that I couldn't walk or stand and couldn't understand. I stayed in Craig Hospital for approximately 3 months to 3 and a half months. The medication they were giving me made me tired and the doctor was waiting to see me when I went back he said he was going to give me a med that would help me stay awake.
He gave me the lowest dose of Ritalin. It has helped with my attention span. I only wish I could of gotten something to help with memory. I was a nurse and found out I couldn't go back to work. I tried. I even contemplated going through a refresher course for RNS but they told me I couldn't go back to work. I filed for social security but have been denied for 7 yrs. I got a letter saying they weren't denying I was disabled but that I had to much equity. That I needed to get a devotee or I needed to sell everything. I was only allowed 3000. I think it is just crazy. I need to find out if anyone knows how I could get some assistance because right now we have no income. If anyone knows how I could get money to pay my electric bill. I can't work and there is no money that comes into the home. Does anyone out there have any advice that they are willing to share with me to help me get out of this mess?

Jan 13th, 2017 12:57am

I was just put on ritalin. My TBI was in 1995 and I've taken many meds for it since but nothing for concentration. We didn't know just how bad it was until I restarted college after all these years (Vocational Rehab). What a difference. I struggled to pay attention, therefore remember, half the things in class. Now, no problem. Hopefully, this semester will go better :)

Jan 3rd, 2017 6:14pm

I have been getting neurofeedback treatment to stimulate my brain (I'm 18 months post TBI) and I like it much better than taking a medication. I'm only 5 weeks into treatment and am already seeing improvements. Might be worth looking into for your situation.

Aug 16th, 2016 4:10pm

I was diagnosed with ADHD four years post severe TBI. It took me a number of years to recognize that I do indeed have quite a few of the problems generally associated with ADHD. I've been very suspicious of the ADHD title, but given the past several years of taking the drug, I've found that the drug can hold positive results for both those of with ADHD and those with a severe TBI. Given this, I recommend that folks in a similar predicament talk to their primary care physician about giving this a try.

Aug 10th, 2016 11:02pm

I suffered three brain injuries in one year. That was eleven years ago. I was taking Focalin for Adult A.D.D. before the injuries. Afterwards the Dr's wanted to slowly add my pre-TBI meds back in to make sure that I was responding well. I felt like my brain was in hyper drive. I literally spun in circles when trying to accomplish anything. Too many signals! I spoke with my neurologist and she described it as "ADD on Steroids" and suggested I contact my psychiatrist about resuming the Focalin. I did exactly that but the Focalin didn't help at all. I was switched back to Adderal and yes it slowed my brain, so much so, that it knocked me out! I couldn't stay awake for anything. In the end my doctor and I decided to drop the ADD medication and I started taking medication for Alzheimer's. That medication allowed me to function much better. I still have an under stimulated brain and I still require assistance with most basic personal care issues like showering, brushing my teeth, dressing, etc. I can see or recognize what needs to be done but without help, I am helpless to act on it. I can shower without help but only if my caregiver physically nudges me to the bathroom. There isn't much I can do without someone telling me exactly what to do. For instance, if my husband were to ask me to fix lunch for us, I would likely be wandering around the kitchen with no idea how to get the job done. If he had said, "please fix me a ham and cheese sandwich with mustard and a dill spear on the side.", no problem! I hate the way my brain works now but at least now I know how to make use of what function I've got. My husband and caregiver now know that I am willing to do things but I can only respond if directed appropriately.

Jun 24th, 2016 3:52pm

In my case the answer is yes. Many years after my initial concussion as a teenager and after having a couple more my doctor prescribed Ritalin XR for what was thought to be ADHD. It wasn't ADHD but the symptoms were very similar. It was like I got my life back. I only got off of it because I was pregnant. Since then no doctor has even acknowledged that the multitude of concussions I have had are a factor in what I go through on a daily basis. Physicians should really listen to their patients better. It is frustrating to say the least.

Jun 24th, 2016 11:26am

I was prescribed 40-60 mg daily of Ritalin for eighteen months following a mild TBI and cervial injury. While it certainly helped with alertness and attention, my blood pressure was out of control and I lost 20% of my body weight. I continued to sleep (or so I thought) fifteen hours a day, but at least I had some alert periods during the day. However, I continued to have what I felt were Alzheimer's type cognitive issues, blackouts, memory lapses. After much prodding from me (three years worth) I was referred for a sleep study and it was determined that I had severe sleep apnea, sleeping only 3 1/2 hours a night and never completing a sleep cycle. CPAP therapy solved my cognitive problem and the Ritalin was tossed.....I was able to return to work and a normal life.

Jun 24th, 2016 9:40am

The doctors started to give it to my husband when he was in the rehab hospital. My husband was in a wheelchair and not speaking yet and seeming to not be motivated. He started speaking right away, not great conversations but some speaking, and he became much more motivated in his physical therapy. That was 4 months post accident. We had him stop taking ritalin about 10 months post accident because we didn't like some of the risks. He has still improved quite a bit without it. We are now 2 years post accident. He is not on any prescriptions now which was a goal of ours. I am thankful we tried ritalin for a while though. I think it gave him a boost.


 

Jun 24th, 2016 6:42am

I take Dextroamphetamine and it's been immensely helpful.

Feb 1st, 2016 11:18pm

I take focalin.

Jun 1st, 2015 11:01pm

I've been on many different types of prescribed medications for depression and a TBI but I finally found the right combination of medicines that includes Dexedrine. I have my TBI as a result of a gunshot to my head...I suffered from clinical depression before my TBI and it became even worse since having the TBI. I now live without severe depression and I am so very thankful!

Jun 1st, 2015 7:01pm

I take Adderall for a TBI, if I didn't take it I would sleep my life away. I've been taking it since 2010, I tried to get Vyvanse but medicare won't cover it

Dec 30th, 2014 11:48am

My psychiatrist just prescribed me ritalin for post concussion syndrome chronic, it has been over 19 months since being hit in the top of a head with a metal bar. I suffer from all the symptoms you can have. At first I thought I was getting Alzheimers. I have been on Wellbutrin and it helps a bit, but it causes palpitations and raises my blood pressure. I am afraid to take ritalin too. I'm a 52 year old female. I wonder if I will ever be able to work again? I'm an RN. I have to be sharp, precise, on the ball at all times.I do not wabt to harm anyone. I hate taking medicine.I'm on 2 types of seizure medicine, muscle relaxers, pain meds, blood pressure meds,TENS unit, cervical traction everything to try to get better. I am told that 6 months is the window for improvement. I'm stuck. MayGod Bless us eeveryone. Amen.

Nov 22nd, 2014 8:50am

My TBI was back in 1993, a major car accident, an 8-week coma, and 21-years later I am doing pretty well.  I have been taking ADHD type of stimulants for the past 5-years and I have found the right medication for me.  Ritalin worked for me at first, but after several different medications I have discovered that Adderall extended release (name-brand only) works best for me...Trial & error is the name of the game!  I have been a Special Education teacher for 8 years & severely struggled my first couple years without any sort of attention aid.  My wife can also tell when I have missed a pill...I would recommend it, but there is definitely side-effects . . .

Oct 6th, 2014 12:06am

I have a mild TBI from MBA hitting my head on a car at 70km/hr. Been prescribed 40mgLA RITALIN and can now function a lot better! Definitely recommend as my memory is working much better, not sure if it is transferring to long term yet but will see soon.

Mar 17th, 2014 1:54am

i have organic brain disorder...due to numerous head traumas....i dealt with this for many years before diagnosis (bout 6 years ago)...my psych prescribed me ritalin about 5 years ago...what a lifesaver!...my concentration greatly improved..my mood...etc.!...my wife can tell if i miss a pill! hee hee

Mar 3rd, 2014 10:39am

My 25 yr old daughter has been taking Ritalin for TBI for about 3-4 years. It made an immediate positive impact and has been a lifesaver for everyday living with a brain injury. She is more focused, feels she makes better decisions, and it helps elevate her general mood. The first year or so was spent trying to get the right dosage. I immediately notice when she fails to take it. She does have to be evaluated each year. It used to be every 6 months for insurance purposes. It's a controlled substance meant for ADHD, so the insurance company will not cover it without written notes from the doctor as to the reason it was prescribed for TBI.

Jan 31st, 2014 12:31pm

For me, coffee - caffeine compounds (Tirend, NoDoz) work a little to temporarily pay attention a little better.  Caffeine has a different molecular structure than stronger stimulants like Ritalin, Dexedrine, Adderall, Vyvanse, etc.).  The stronger prescription stimulants, for me, fail to work.  Thank you for asking about Ritalin and brain concussions - organic brain syndrome.

Jan 9th, 2014 4:02pm

I have also tried taking Ritalin. It was NOT helpful. It made me more agitated and less able to focus on my work. On top of that, I couldn't sleep. I gave it a couple trials but gave up on it altogether.

Jan 8th, 2014 11:46am

I hae a tbi in 2010 from a second story fall. I have been taking ritalin for a couple of yesrs now. It helps me a lot. Helps me not be so tired and not get as easily annoyed. My husband doesn't think I am angry all the time.

Jan 7th, 2014 2:28pm


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