title: Evaluation of dosage, safety and effects of methylphenidate on post-traumatic brain injury symptoms with a focus on mental fatigue and pain.
abstract: OBJECTIVE
  The neurobehavioural symptoms and pain following traumatic brain injury (TBI) can be long-lasting. The condition impairs the persons' ability to function in their work, studies and gatherings with family and friends. The aim of this study was to investigate dosage, safety and effects of methylphenidate on mental fatigue and pain.
  
  
  METHODS
  Twenty-nine physically-well rehabilitated TBI victims, 28 with a mild TBI and one with TBI and also with pain in the neck, shoulders and head were included in the study. Methylphenidate was tested in each patient using three treatment strategies: no medication, low dose (5 mg × 3) and normal dose (20 mg × 3) for 4 weeks using a randomized cross-over design.
  
  
  RESULTS
  Twenty-four patients completed the three treatment periods. Five participants discontinued, four females due to adverse reactions and one male due to attenuated motivation. Only minor adverse events were reported. Methylphenidate significantly decreased mental fatigue, as evaluated by the Mental Fatigue Scale (p < 0.001), and the effects on mental fatigue were dose-dependent. No effect on pain was detected.
  
  
  CONCLUSIONS
  Methylphenidate decreased mental fatigue for subjects suffering a traumatic brain injury, the treatment is considered to be safe and is recommended, starting with a low dose.
authors.affiliation: Department of Clinical Neuroscience and Rehabilitation, Institute of Neuroscience and Physiology, Gothenburg University , Gothenberg , Sweden .
authors.forename: B
authors.initials: B
authors.lastname: Johansson
authors.forename: A-P
authors.initials: AP
authors.lastname: Wentzel
authors.forename: P
authors.initials: P
authors.lastname: Andréll
authors.forename: J
authors.initials: J
authors.lastname: Odenstedt
authors.forename: C
authors.initials: C
authors.lastname: Mannheimer
authors.forename: L
authors.initials: L
authors.lastname: Rönnbäck
mesh_terms: D000293:Adolescent; D000328:Adult; D000697:Central Nervous System Stimulants / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D018592:Cross-Over Studies; D004305:Dose-Response Relationship, Drug; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D005222:Mental Fatigue / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D008774:Methylphenidate / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D009483:Neuropsychological Tests; D010146:Pain / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D018579:Patient Selection; D038223:Post-Concussion Syndrome / Q000150:complications* / Q000188:drug therapy* / Q000503:physiopathology; D011788:Quality of Life; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000697:Central Nervous System Stimulants; D008774:Methylphenidate