Neuroprotective Effects of Methylphenidate on Diffuse Axonal Injury in Acute Traumatic Brain Injury Patients

This study aimed to evaluate the effect of methylphenidate on the level of consciousness and length of hospitalization of patients with moderate to severe acute Traumatic Brain Injury (TBI) categorized as diffuse axonal injury. This randomized, double-blind clinical trial comprised 62 patients with moderate to severe traumatic brain injury with a Glasgow Coma Scale (GCS ) between 5 and 12 referred to our emergency department. Methylphenidate tablets were administrated from the second day with a dose of 0.3 mg/kg up to a maximum of 20 mg daily. A placebo was administered in the same manner and the patient's level of consciousness, delirium using the Confusion Assessment Method for the intensive care unit (CAM-ICU), agitation using Richmond Agitation Sedation Scale (RASS), and predicting the outcome of patients with GOS, were assessed. The patients' GOS on the day of discharge was significantly higher in the intervention group (P=0.013). The duration of hospitalization was significantly shorter in the intervention group (P<0.001). The patients' GCS upon discharge was significantly higher in the intervention group (P=0.01). Our results suggest that methylphenidate has some beneficial effects on the consciousness level and outcomes of patients with acute TBI. The use of methylphenidate also reduces the length of ICU stay and hospitalization and improves the outcome in patients with moderate to severe TBI not requiring surgery.