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Title: The efficacy and safety of extended-release methylphenidate following traumatic brain injury: A randomised controlled pilot study.
Epworth Authors: Dymowski, Alicia Rhian
Ponsford, Jennie
Owens, Jacqueline
Olver, John
Ponsford, Michael
Willmott, Catherine
Keywords: Methylphenidate
Speed of Processing
Traumatic Brain Injury
Extended-Release Methylphenidate
Complex Attentional Functioning
Attentional Behaviour
Acquired Brain Injury Rehabilitation Program
Alternative Treatments
Monash-Epworth Rehabilitation Research Centre, Epworth HealthCare, Victoria, Australia
Epworth-Monash Rehabilitation Medicine Unit, Epworth HealthCare, Victoria, Australia
Issue Date: Jun-2016
Publisher: Sage
Citation: Clin Rehabil. 2016 Jun 27. pii: 0269215516655590
Abstract: OBJECTIVE: To investigate the feasibility, safety and efficacy of extended-release methylphenidate in enhancing processing speed, complex attentional functioning and everyday attentional behaviour after traumatic brain injury. DESIGN: Seven week randomised, placebo-controlled, double-blind, parallel pilot study. SETTING: Inpatient and outpatient Acquired Brain Injury Rehabilitation Program. PARTICIPANTS: Eleven individuals with reduced processing speed and/or attention deficits following complicated mild to severe traumatic brain injury. INTERVENTIONS: Participants were allocated using a blocked randomisation schedule to receive daily extended-release methylphenidate (RitalinĀ® LA at a dose of 0.6 mg/kg) or placebo (lactose) in identical capsules. MAIN OUTCOMES: Tests of processing speed and complex attention, and ratings of everyday attentional behaviour were completed at baseline, week 7 (on-drug), week 8 (off-drug) and 9 months follow-up. Vital signs and side effects were monitored from baseline to week 8. RESULTS: Three percent (n = 11) of individuals screened participated (mean post-traumatic amnesia duration = 63.80 days, SD = 45.15). Results were analysed for six and four individuals on methylphenidate and placebo, respectively. Groups did not differ on attentional test performance or relative/therapist ratings of everyday attentional behaviour. One methylphenidate participant withdrew due to difficulty sleeping. Methylphenidate was associated with trends towards increased blood pressure and reported anxiety. CONCLUSION: Methylphenidate was not associated with enhanced processing speed, attentional functioning or everyday attentional behaviour after traumatic brain injury. Alternative treatments for attention deficits after traumatic brain injury should be explored given the limited feasibility of methylphenidate in this population.
DOI: 10.1177/0269215516655590
PubMed URL:
ISSN: 1477-0873
Journal Title: Clinical Rehabilitation
Type: Journal Article
Affiliated Organisations: School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Australia.
Type of Clinical Study or Trial: Double-Blind Method
Appears in Collections:Neurosciences
Research Month

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