do medications really help with a concussion

Collection of medicines “for boys” – very slippery topic.

More than once, we may come across a request to hand over money for drugs that evidence-based medicine has labeled “ineffective.”

It can also be specific branded drugs, often not cheap.

And there may be something from folk medicine, made in dubious conditions, by people who have neither medical nor pharmaceutical education.

The main argument of such gatherings is: “boys are asking.”

However, volunteer and neurologist Oleksandra Shchebet says that everything is not so simple.

Sometimes boys and girls ask because combat medics ask. And combat medics, like all people, can make mistakes.

“From the experience of our fund – they asked the doctors through the boys, and I sent them to the known address of the doctors through the boys, because they were afraid to write to me directly“, – says the doctor.

We have already written about which dubious drugs are the most common find themselves among volunteer gatherings.

Most often it is:

• antiviral;
• aescinic salt;
• some vitamins;
• phytotherapy, etc.

However, today we want to focus on a very controversial group of drugs, namely the so-called “neuroprotectors”.

These are often expensive drugs for which funds are raised in the hope of helping soldiers better cope with what is popularly called contusions (that is, with craniocerebral injuries).

What is expected from such drugs?

“They want the recovery of all brain functions “up to 100% level”, improvement of memory, attention, concentration, so that it becomes “clearer” in the head.

Often they are also expected to get rid of headaches, dizziness, fatigue, sleep problems“, – says Oleksandra Shchebet.

But everything is not so simple.

And not only drugs are needed for this. So what?

What is wrong with these fees? And drugs? And what really helps with brain injuries?

Let’s try to understand neurology Alexandra Shchebet and a pharmacist Andrii Chimbare.

And to begin with, an important note:

Not all questionable drugs should be called “fuflomycins”

There are drugs whose ineffectiveness has been proven.

That is, a whole series of clinical studies showed that the drug – it is essentially “empty”.

But there is another category of drugs.

These are drugs with unproven effectiveness.

That is, we can assume that the drug has an effect, but there is no evidence of sufficient effectiveness.

And this is where the main conflict between patients/volunteers/doctors begins.

“These agents that you often see labeled with the prefix “neuro” are not fuflomycins. It generics drug citicoline. About 10 years ago was great research, how this drug affects traumatic brain injuries. And this study turned out to be a big disappointment: the placebo effect was more pronounced than the effect of this drug.

Despite the fact that patients with injuries of varying severity took this drug in fairly high dosages for 3 months“, – says the doctor.

At most, it is not entirely correct to call these drugs neuroprotectors.

As Andriy Chymbar explains, the indications for citicoline in the instructions are as follows: stroke, craniocerebral injuries, and chronic cerebrovascular disorders.

“In other words, these are drugs for the treatment of the consequences of conditions and diseases specified in the instructions. This is not a pill, the task of which – protect nerve cells from something“, – adds the pharmacist.

Some patients say that this drug helps them. And someone does not feel any effect:

“However, given its cost, the need for long-term administration, but questionable effectiveness, most countries did not approve the use of citicoline“, – says Oleksandra Shchebet.

And here we come to the main problem, which cannot be replaced by any drugs.

The best thing to do for a “concussion” – it’s to rest

“A day, or better two. And these are the minimum terms. Doctors usually recommend resting as much as possible, at least up to a week – unless it’s combat conditions.”, – the neurologist insists.

What we used to call contusion – this is a somewhat outdated term.

Contusion – this, as we mentioned at the beginning, is a craniocerebral injury. And the best and first aid for it – sleep and rest.

We can already hear your outrage at this point. No one gives boys and girls a day off after a concussion.

Especially two.

And these drugs – it is like an act of desperation: it is necessary to do at least something. However, one pill of very expensive citicoline will not make your neurons regenerate. Even if you take these drugs – then a long course, says Andrii Chymbar.

What to do?

Unfortunately, how to fix it, medicine has no answer.

The answer should be those who are working on the law on mobilization to finally provide the brigades with a sufficient number of people, which, in turn, will allow them to lie down after an injury, and not to hold a position.

However, in this text we want to articulate how it should be.

We believe that gradually our army will come to this.

And so we repeat:

“No drug can replace sleep and rest in the first days after an injury.

This is our neurophysiology. There is no substitute for the brain’s ability to repair itself and cleanse itself in a state of sleep and rest. Without unnecessary stimuli, including gadgets. This applies to traumatic conditions and not.

But in trauma it is critically important. Because it is necessary to do everything so that distant consequences do not develop”, – says the neurologist.

Implied?

It is impossible to overexcite a person, overexcite his neural connections, it is important to avoid an increase in swelling, risks of microinflammations of the brain, etc.

Twitter emphasizes: do not let the brain rest – is to get chronic consequences of brain injury.

The idea is that this drug will solve everything and a person can be sent to boarding without rest – to some extent maintain the neglect of the problem.

However, are concussion/TBI drugs generally necessary? Of course.

Any brain injury is unique.

“To begin with, these will be drugs that will relieve the symptoms. Some will need medication to reduce swelling. to someone – pain relievers, anti-nausea, etc.

And then drugs are added to prevent long-term consequences. But these will not be so-called “neuroprotectors”, but effective psychostimulant drugs with a dosage determined for this specific case. Some will need antidepressants“, – explains the neurologist.

It is better for combat medics to consult with neurologists/intensivists, who will help understand the needs and purchase something that will definitely work, and not create the illusion of activity, adds Shchebet.

In addition, Oleksandra Shchebet emphasizes that “contusion” – it’s not just about brain injury. This is a whole spectrum of symptoms that affects different systems of our body. So no, there are no miracle drugs that will fix it quickly.

There is no single drug for traumatic brain injury.

But you can support the person and help them recover

Recovery after TBI – it’s a process. For some, it will last longer, for others – Less. But a person needs time, support and understanding to recover. This statement applies to everyone: military personnel, athletes, people who survived road accidents, were injured at work, etc.

Some sometimes a person can be tortured headaches, dizziness, she may be more irritable, get tired more quickly, have problems with memory and concentration.

No, this is not the scary PTSD that bloggers scare the middle class with.

Here’s how the Washington State Health and Human Services Manual describes it:

“A TBI survivor may experience loss of independence, fatigue, overstimulation, or cognitive problems, which in turn can lead to feelings of frustration and anger.”

The patient may experience or exhibit the following:

✅ a strong reaction to minor factors of irritation or causes of disappointment;

✅ increased irritability;

✅ increased tendency to anger;

✅ lack of patience;

✅ low tolerance for changes;

✅ unexpected outbursts of anger;

✅ verbal or physical demonstration of anger;

✅ all of the above or a combination of the above factors.

It is important to understand that these reactions are gradually minute.

But what can you do now?

To start – stop Assess the situation. What caused this situation?

Is human behavior dangerous? How can you change the conditions to make things better?

Imagine this:

Your partner has come on vacation after being in a war zone. He/she had a moderate TBI, the person received treatment and is currently able to recover a bit at home.

But the sounds of the blender started to annoy her/him.

What is the trigger here? Of course, a loud and unpleasant sound.

How can this be solved? For a while, refuse to use it or grind food when the person is not at home.

These are temporary precautions, but they are important during the recovery phase.

AntonLozovoy/Depositphotos

Also a neurologist and director of the Center for Rehabilitation and Mental Health of War Veterans “Lisova Polyana” Ksenia Voznitsyna in video for Veteran Hub notes that the patient’s active involvement in their own recovery is extremely important.

First of all, it is:

Sleep. It’s worth it go to bed at the same time (approximately 10-11 p.m.), ventilate the room before that, do not use gadgets 2 hours before bedtime. Take a walk with a friend, loved one, dog, or just your thoughts. Read a printed book, have a light dinner, don’t overeat, don’t drink coffee after dinner.

Food. There is food that the brain “loves”, says Ksenia Voznitsyna.

In particular, it is:

• fatty fish;
• vegetables;
• eggs;
• chocolate;
• nuts;
• green tea;
• turmeric;
• forest berries

Physical activity. The fact that physical exercises after a concussion are prohibited – a harmful myth. Of course, you should return to activities gradually. But already 2-3 days after the injury, a person will be advised to move more actively. Dosed aerobic loads, attention to one’s own well-being help to recover, not the other way around. A person will be helped by brisk walking, yoga, swimming, etc.

Psychotherapy. A professional psychotherapist will help you adjust your lifestyle and regulate the emotional sphere. This is important regardless of a person’s military experience.

Just as people are looking for a magic pill for their own civil problems, so they are looking for a magic pill for “contusions”.

But it does not exist.

If we want soldiers to recover, we need evidence-based methods, respite between combat engagements, an opportunity to recover.

And for this, you don’t need magic pills, but if it didn’t sound paradoxical – people. And those who will support, and those who will replace.

Natalya Bushkovska, especially for UP. Life