• H Bascuñana, I Villarreal, S Alfonso, M Bernabeu, and R Terré.
• Unidad de Lesión Cerebral, Institut Guttmann, Barcelona, España. ib307848@public.ibercaja.es
• Rev Neurol. 2000 May 1; 30 (9): 850-4.

ObjectiveTo carry out a bibliographic review of articles indexed in MEDLINE over the past 20 years concerning the pharmacological treatment of agitation in head injury.DevelopmentHead injury may cause different behaviour changes, of which agitation is the most dramatic. The incidence of agitation after severe head injury varies from 11% to 50% depending on the study involved. This incidence is high enough to warrant specific management. Drug treatment has variable results. When there is imminent danger of harm to the patient himself or to others, or when aggressive behaviour makes medical management difficult, the benzodiazepines have been found useful. Antipsychotic drugs are only indicated in head injury when the agitation causes a clinical emergency, and in such a case the more potent drugs such as haloperidol are best, since they have less sedative effect. They are also effective when the clinical features are similar to those of classical schizophrenia. Antiepileptic drugs have been used successfully for treating agitation-aggressiveness, specially in paroxystic behaviour disorders. We also consider other treatments used for posttraumatic agitation.ConclusionThere is no general agreement amongst doctors as to the best treatment for posttraumatic agitation in head injury. However, with regard to certain characteristics of agitation different drugs may be recommended for treatment.

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