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Postconcussion syndrome treatment should include pharmacological, natural therapies

Postconcussion syndrome treatment should include pharmacological treatments as well as natural treatments to reduce risk for prolonged or future neurocognitive deficits associated with concussions.

“Despite the high prevalence of traumatic brain injury, and the subsequent occurrence of neuropsychiatric sequelae, our evidence-based treatment strategies are thus far confined to physical therapy and rehabilitation medicine,” Andrew Farah, MD, DFAPA, of the University of North Carolina Healthcare, wrote.

Currently, there are no standardized medications or natural-based treatments for postconcussion syndrome (PCS), according to Farah.

To inform clinicians on best practices for treating PCS, Farah reviewed pharmacology used to treat specific symptoms of PCS and natural strategies recommended for long-term use.

Traditionally, pharmacological treatments have been limited to providing symptomatic relief, according to Farah. However, at least 20% of individuals with PCS have persistent symptoms for more than 6 months and some experience indefinite symptoms.

Because of this, Farah recommended including neuroprotective strategies in PCS treatment to reduce risk for prolonged symptoms and future dementias.

“Because every head injury is unique in occurrence and each brain is unique with regards to its underlying vulnerabilities, each cluster of neuropsychiatric symptoms is uniquely derived,” Farah wrote. “The traditional approach of symptomatic targeting should be combined with neuroprotective strategies. Specifically, the use of [N-acetyl cysteine], [homocysteine]-lowering reduced B vitamins, and omega-3 fatty acids, not only postinjury, but in future protocols as prophylactic measures for athletes, and anyone at occupational or recreational risk of [traumatic brain injury] could, in my view, eliminate or reduce future disability in countless patients.”– by Amanda Oldt

Disclosure: Farah reports receiving grant/research support from AltheaDx, serving as a consultant for Jaymac Pharmaceuticals; and on the speaker’s bureaus for Otsuka and Jaymac Pharmaceuticals. Please see the study for a full list of relevant financial disclosures.