Dementia in Head Injury
Medications for Dementia After a Head Injury continued...
These drugs often work well in behavior disturbances (aggression, agitation) that occur as complications of head injury. They work by stabilizing mood. Examples include carbamazepine (Tegretol) and valproic acid (Depacon, Depakene, Depakote).
Like some antiepileptic drugs, the drug lithium (Eskalith, Lithobid) is a mood stabilizer. It is helpful in calming explosive and violent behavior. Lithium also decreases impulsive and aggressive behavior.
These drugs are sometimes used cautiously to quickly relieve agitation or violence on a short-term basis in people with dementia. They have other uses, such as treating insomnia and relieving anxiety. However, they can worsen cognitive and behavioral problems (e.g., impulse control) in people with head trauma and are therefore generally not recommended in head-injured persons with dementia, except when needed to calm a person rapidly. Examples are lorazepam(Ativan) and diazepam(Valium).
These drugs work well in treating aggression in some people with head injury. They also reduce restlessness and agitation. An example of these drugs, which are most widely used to lower high blood pressure, is propranolol (Inderal).
Other Therapy for Dementia After a Head Injury
Persons who are unable to prepare food or feed themselves are in danger of becoming malnourished. Their diets must be monitored to be sure that they are getting proper nutrition. Dementia patients who may have a poor gag reflex or difficulty swallowing may need special medical assistance for obtaining nutrition. Otherwise, no special dietary prescriptions or restrictions apply.
In general, the person should be as active as possible.
In the early phases of rehabilitation, simple physical exercises and games may improve endurance and self-confidence. These activities should gradually increase in difficulty.
Some head-injured persons may require devices to help them with mobility (walking or moving around). Persons using such mobility aids require monitoring to make sure they are safe.
It may be necessary to change the surroundings to prevent falls and accidents that could cause repeat injuries.
Although medical professionals often recommend that the head-injured person resume normal activities or responsibilities, this is not always easily done. People who work at night, or whose work involves heavy machinery, hazardous conditions, or an overstimulating environment, may not be able to return to their previous positions. Returning to work before the person is ready may lead to failure and regression in recovery. The person may delay returning to work or previous activities for fear of further injury, embarrassment about disabilities, and uncertainty about abilities. A gradual return to work that allows the person to relearn or get used to the job is often helpful, although not always possible.
People who play contact sports should not return to play until cleared by their health care provider. Even a mild head injury makes the brain more fragile. A second blow to the head, even a very slight one, could cause a person with a recent head injury to die of sudden brain swelling. This is called second injury syndrome.