Treatment of chronic closed head injury with psychostimulant drugs: a controlled case study and an appropriate evaluation procedure.

The psychostimulant drugs methylphenidate (MPH) and dextroamphetamine (DEA) have proven efficacy in clinical populations whose primary symptoms include disorders of attention, impulse control, and locomotor hyperactivity. These medications have also been shown to influence in a positive manner cognitive functioning, particularly in the areas of sustained attention and memory. In light of these facts, the psychostimulants MPH and DEA were administered in separate trials to a young man who suffered from similar symptoms secondary to a chronic closed head injury. The medication trials were double-blind, placebo-controlled, dose-response studies. Cognitive functions, particularly memory and attention, improved in the active drug conditions. In addition, there was a consistent, positive drug effect across behavioral assessments. This case study emphasizes the importance of studying psychostimulant effects in patients with neuropsychological and behavioral sequelae of closed head injury; it also presents an appropriate methodology for evaluating psychostimulant effects in a clinical research setting.