title: Predictors of Pharmacological Intervention in Adolescents With Protracted Symptoms After Sports-Related Concussion.
abstract: BACKGROUND
  Although recovery after concussion is spontaneous and typically occurs within 2-3 weeks, a subset of adolescents develop persistent symptoms after a sports-related concussion. Medications are frequently prescribed as part of a comprehensive treatment approach to alleviate these symptoms; however, there are no guidelines for prescription of pharmacologic therapy after concussion.
  
  
  OBJECTIVE
  To investigate common factors that are associated with the use of medications (antiepileptic, antidepressant, neurostimulant, or sleeping medication) during recovery from a sports-related concussion.
  
  
  METHODS
  Retrospective observational study.
  
  
  METHODS
  Single-center specialty concussion center.
  
  
  METHODS
  A total of 100 adolescents, between the ages of 12 and 18 years, who sustained concussion due to sports.
  
  
  METHODS
  Independent variables collected included age at the time of concussion, gender, sports played, personal history of prior concussion or mental health disorder, and personal or family history of headache (eg, migraines) or seizure disorder.
  
  
  METHODS
  Prescription of medications for treatment of concussion.
  
  
  RESULTS
  Twenty-four patients (24%) were prescribed medications in this study, all of whom reported headache at the time of medication prescription. Amantadine was the most commonly prescribed medication, with amitriptyline and melatonin also being prescribed. Among the demographic information collected, only age and gender met criteria for inclusion in the regression model. Logistic regression analysis demonstrated that the odds that female participants were prescribed medications was 3.790 (95% confidence interval = 1.262-11.380) higher than male participants. A higher symptom score on the initial Post Concussion Symptom Scale (PCSS) was associated with increased odds of being prescribed medications (odds ratio = 1.031, 95% CI = 1.009-1.052).
  
  
  CONCLUSIONS
  The current study found that initial symptom severity and female gender were associated with use of medication in recovery from sports-related concussion among variables available for study.
  
  
  METHODS
  II.
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Pittsburgh Medical Center, Pittsburgh, PA(∗).
authors.forename: Shanti M
authors.initials: SM
authors.lastname: Pinto
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Pittsburgh Medical Center, Pittsburgh, PA; UPMC Rehabilitation Institute, UPMC Mercy Hospital, 1400 Locust Street, Pittsburgh, PA 15219(†). Electronic address: twichellmf@upmc.edu.
authors.forename: Maria F
authors.initials: MF
authors.lastname: Twichell
authors.affiliation: Sports Concussion Program, University of Pittsburgh Medical Center, Pittsburgh, PA(‡).
authors.forename: Luke C
authors.initials: LC
authors.lastname: Henry
mesh_terms: D000293:Adolescent; D000547:Amantadine / Q000008:administration & dosage*; D000927:Anticonvulsants / Q000008:administration & dosage*; D001265:Athletic Injuries / Q000150:complications* / Q000503:physiopathology; D001924:Brain Concussion / Q000188:drug therapy* / Q000209:etiology* / Q000503:physiopathology; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015601:Injury Severity Score; D016015:Logistic Models; D008297:Male; D038223:Post-Concussion Syndrome / Q000188:drug therapy / Q000503:physiopathology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants; D000547:Amantadine