A Clinical Review of Mood Stabilizers in Traumatic Brain Injury

Our aim was to provide an update on the use of mood stabilizers for agitation in traumatic brain injury patients, with a summary of each agents’ mechanism of action, efficacy in managing agitation, common adverse events, and important rehabilitation considerations.

Animal studies show the use of valproic acid after traumatic brain injury may promote early neurological recovery and reduce secondary brain injury in the acute period. It also has benefits for seizure prevention and headache management. Lithium use early in the post-traumatic period may similarly offer neuro-protective benefits at lower doses.

Animal studies and more recent meta-analyses and systematic reviews show emerging efficacy for valproic acid and carbamazepine in treating post-traumatic agitation, with notable side effects that need to be monitored for and managed in the TBI population. The potential use of lithium in the acute post-traumatic period may also promise to prevent secondary brain injury.