Subjective improvement following treatment with carbamazepine (Tegretol) for a subpopulation of patients with traumatic brain injuries

Over a 3-yr period, 19 patients who had sustained brain traumas during moto r vehicle incidents and who exhibited abnormal scores for a dichotic word-l istening task and Roberts' Epileptic Spectrum Disorder Inventory more than one year after the injury were recommended for treatment with carbamazepine (Tegretol). The psychiatric profile of these patients, as defined by the M innesota Multiphasic Personality Inventory, was similar to the profile of p atients from other studies who had displayed more objective improvement fol lowing this treatment. Of the 14 patients 12 who followed the recommendatio n retrospectively reported that within a few weeks after treatment they exp erienced marked reductions in the incidence of sudden confusion and depress ion, increased attention and focus, and either elimination or attenuation o f an aversive sensed presence. Such results suggest that many of the debili tating symptoms that persist for months to years after a traumatic brain in jury may be electrical in nature rather than due to "psychological response s" and might be treatable by appropriate dosages of carbamazepine or other, e.g., Gabapentin (Neurontin) antiepileptic compounds.