Carbamazepine in agitation and aggressive behaviour following severe closed-head injury: results of an open trial

Ten patients presenting agitation and anger outbursts at Various stages fol lowing a severe closed head injury, were treated in a prospective open tria l with carbamazepine, with doses ranging from 400 to 800 mg per day, during 8 weeks. Group analysis demonstrated a statistically significant improveme nt of a score made up from six target items from the neurobehavioural ratin g scale. Improvement mainly concerned irritability and disinhibition. A sta tistically significant improvement was also found with the Agitated Behavio ur Scale. Social functioning, as assessed by family or staff ratings of the Katz Adjustment Scale, also significantly improved. No modification of glo bal cognitive functioning was found with the Mini Mental Status Examination . Individual analysis demonstrated that the beneficial effect was important in five cases, moderate in three patients and negligible in two cases. It is concluded that carbamazepine might help to reduce agitated behaviour in brain-injured patients. However, response to treatment demonstrated an impo rtant inter-individual variability.