Depression drug could delay brain injury recovery

Drugs used to treat a broad range of common conditions including bladder problems, insomnia and depression could delay the recovery of brain injury patients, new research has found.

The study noted that these drugs may have anticholinergic properties that are often used on neuro-rehabilitation units frequently to manage symptoms from urinary incontinence to pain.

Anticholinergics are already known to have side effects such as temporary cognitive impairment, dizziness and confusion. 

But their effects on people with pre-existing brain and spinal injuries have not been investigated until now.

"This work adds to the evidence that anticholinergics should be avoided in a wide-range of populations, when possible,” said one of the researchers Ian Maidment, senior lecturer in clinical pharmacy at Aston University in Birmingham, England.

"Regular medication review by a nurse, doctor or pharmacist may be a way of ensuring that medicines with anti-cholinergic effects are used appropriately," Maidment noted.

The study of 52 patients with acquired brain or spinal injury at a neuro-rehabilitation unit showed that the average length of stay was longer in patients with a higher level of anticholinergic drugs in their system, known as the anticholinergic drug burden, or ACB.

Results showed that the change in ACB correlated directly to the length of hospital stay. 

"While medications with ACB are often needed to treat common complications of brain or spinal cord injuries, cognitive impairment due to the medication may adversely affect a patient's ability to engage in the rehabilitation process, potentially increasing their length of stay in hospital," lead study author Chris Fox, professor University of East Anglia in Norwich, England.

The study was published in the journal Brain Injury.