Antiepileptic medications in the treatment of neuropsychiatric symptoms associated with traumatic brain injury

Traumatic brain injury (TBI) is a significant cause of morbidity and disability in the United States. The Center for Disease Control (CDC) estimates that an average of 1.4 million people suffer from a TBI in the United States each year (1). Children under the age of 14 years account for 475,000 incidents of TBI each year, while older adults (>65 years) account for 83,000. According to the CDC, males are 1.5 times more likely than females to suffer from a TBI. The severity of TBI can range from mild to severe. Mild TBI is defined as a brief change of consciousness or mental status following injury, while a severe brain injury is defined as an extended period of unconsciousness or amnesia following the incident. Studies by the CDC approximate that the annual death rate secondary to TBI is about 50,000. Approximately 16.8% patients require hospitalization and 79.6% require visits and care in an emergency department. In addition to acute care, many patients require long-term rehabilitation and suffer from chronic sequelae such as posttraumatic epilepsy, impaired cognition, and long-term neuropsychiatric syndromes (1).