METHYLPHENIDATE IN THE TREATMENT OF COMA

While there is significant morbidity and mortality involving patients in semicomatose and comatose states, the care of such patients has tra ditionally been limited to supportive measures. We report two cases of patients treated with methylphenidate hydrochloride: the first, a pat ient in a semicomatose state resulting from traumatic brain injury, an d the second, a patient in a comatose state secondary to a subdural he matoma that occurred after a fall. Treatment with methylphenidate may provide neurostimulations by augmenting the activity of injured neuron al tissue within the reticular activating system, and by amplifying th e net effect of the reduced number of viable neurons. Methylphenidate is a low-cost, potentially efficacious intervention for reducing the d uration of comas, for preventing life-threatening and costly complicat ions of prolonged unconsciousness, and for promoting early ambulation and recovery. Further research using more rigorous research designs to ascertain the effectiveness of methylphenidate in the treatment of pa tients in semicomatose and comatose states is needed.