50+ Medications for Concussions and Post-Concussion Syndrome: What Works, What Doesn’t, and What to Do Instead
Whenever we hold a new patient consultation, we discuss the medicine and supplements that patient has been taking for concussion symptoms. We see a variety of medications for concussion that doctors throughout the U.S. and Europe are prescribing. We also see if they’ve been helping or hindering our patients.
In this article, we’ll break down some of the most common medications for post-concussion syndrome, organized by the most common symptoms of concussion we see in our patients, along with things to consider if you’re taking them:
- Medication for anxiety, depression, and feelings of being overwhelmed
- Medication for sleep difficulties
- Medication for headaches, migraines, and other pain
- Medication for dizziness and nausea
- Medication for concentration and other cognitive issues
- Medication for chronic fatigue, low energy, and low motivation
- Medication for light and noise sensitivity
- Medication for vision problems
- Medication for blood pressure dysfunction
- Bioidentical hormone replacement
- Popular natural remedies
In the right situation, some of these medicines will help keep your symptoms manageable. But medications don’t fix the underlying problems caused by a traumatic brain injury. Instead, they often mask the problem, making it more difficult to identify and fix.
For any patient with lingering concussion symptoms, we strongly recommend active rehabilitation at a good concussion clinic rather than relying on medication. Medications often come with side effects and/or long-term consequences. And if you’re taking multiple medications to manage post-concussion symptoms, that puts a notable strain on your liver. Anything you can do to relieve or minimize symptoms without medication is usually better for your overall health.
At Cognitive FX, our patients improve by 75% on average after treatment at our center specializing in post-concussion therapy. To see if you are eligible for treatment, sign up for a free consultation.
Medications for Anxiety, Depression, and Feelings of Overwhelm
Medications for emotional symptoms are complex. If you had a history of mental illness before your concussion and are taking medications for it, concussion treatment is not likely to decrease your need for those medications. But if your mental health declined after your head injury, you may be able to wean off them after treatment as the underlying cause rectifies.
Your exact dosage and medication should be managed by your physician; if we ever recommend changing doses, it’s under the condition you are working with a licensed medical practitioner at home to do so. However, we often encourage patients not to take unnecessarily excessive amounts of these medicines. Sometimes, patients are able to wean off before their treatment at our clinic begins. This is sometimes the ideal situation because medications for anxiety and depression, when prescribed for concussion management, could interfere with concussion treatment.
Here are some of the more common medications we see our patients using to handle anxiety, depression, feelings of being overwhelmed, and other emotional symptoms:
- Amitriptyline, such as:
- Benzodiazepines, such as:
- Alprazolam (Xanax)
- Diazepam (Valium)
- Selective serotonin reuptake inhibitors (SSRIs), such as:
- Citalopram (Celexa)
- Escitalopram (Lexapro)
- Fluoxetine (Prozac)
- Sertraline (Zoloft).
Note that benzodiazepines have a high addiction component. They can take years to wean off successfully. In addition, they often make other symptoms worse because they can make cognitive tasks more difficult.
Some patients also use marijuana and marijuana extracts, which we cannot recommend because there isn’t much research on marijuana and its effect on the brain, especially when it comes to mTBI patients. Ultimately, we don’t recommend anything that doesn’t have research to back up its safety and effectiveness.
Medication for Sleep Difficulties
Patients have come to us taking a variety of medications for sleep disturbances. There is some overlap with the medications listed above, but sometimes patients resort to, shall we say, creative solutions which aren’t good for their long-term health. Here’s what we’ve seen:
- Please don’t do this; there are much healthier ways to get a good night’s sleep.
- Antihistamines, especially Benadryl
- Note: If you’re taking antihistamines to help you sleep, stop immediately. Long term use is extremely detrimental to your health.
- Diazepam and some other benzodiazepines (see the above section)
- Doxepin, such as:
- This is an over-the-counter supplement rather than a medication, per se. Taken according to instructions, it can enhance your sleep in a natural way.
- Trazodone, such as:
Some of these solutions — such as alcohol and antihistamines — are extremely dangerous. If you’re taking either to help with sleep (regardless of whether it’s because of a mild traumatic brain injury), please see a doctor to help you transition to something safer.
Of all the options on this list, melatonin is the safest and least addictive. Overall, melatonin is a good option.
Medication for Headaches, Migraines, and Other Pain
Headaches are an extremely common persistent symptom. There are myriad medicines you can take to control chronic pain, especially when it comes to headaches and neck pain. Here are a few we’ve seen patients take:
- Amitriptyline (as described above)
- CBD oil
- Note that no studies have been done on the long-term effect CBD oil has on the human brain. CBD oil is a popular choice because patients see it as a way to handle headaches and other ailments, but we cannot recommend it because we don’t know what effects it may have long-term, especially when it comes to the brain and concussion recovery.
- Muscle relaxants
- These are often used by patients with tension-type headaches and neck pain.
- Over-the-counter pain relief, such as:
- Acetaminophen/Paracetamol (Tylenol)
- Sumatriptan (Imatrex)
- Topiramate, Topamax
- This medicine, in particular, tends to make other symptoms — like brain fog and short-term memory loss — worse.
- This is a highly addictive narcotic for pain. If you’re on it, you may need to work closely with your doctor to wean off this drug.
We’ve also seen patients on a number of drugs listed in the section on anxiety and depression that they use for pain management.
One of the biggest problems with pain medication in post-concussive syndrome patients is that the medicines result in an overall dampening of neural networks. Why is this a problem? Neuroplasticity is a key component in recovery from a mild TBI. If your neural networks are dampened, it’s harder for your brain to recover from the head trauma you sustained.
Medication for Car Sickness, Balance Problems, Nausea
There are many fewer medications we see patients using to control car sickness and nausea, but these two are by far the most common:
- Scopolamine patch.
Most of the time, we recommend patients wean off as many medications as they can before post-concussion treatment. After all, the fewer medicines you have meddling with your brain chemistry, the easier it is to repair damage from your injury. But anti-nausea medicine is one of the exceptions. Some patients can live without it, and some can’t. If you really need the medicine, it’s better to take it and be safe.
With the right physical therapy and cognitive therapy, you may be able to wean off these medicines over time.
Medication for Concentration Issues and Other Cognitive Symptoms
There aren’t many medications you can take to recover cognitive function from postconcussive symptoms. For patients experiencing difficulties following a conversation or a shortened attention span, some doctors prescribe ADD or ADHD medications. Some of our patients have used these two:
Both are stimulants and can be addictive. Most people are able to take them as needed, some find that they help, and some report no improvement in their symptoms while on the medication. Ultimately, if your doctor diagnoses you with ADD or ADHD as an adult after you’ve had a head injury, there is a good chance those symptoms were caused by the head injury rather than “true” ADD/ADHD.
If your symptoms do stem from a concussion, there is a way to improve them without medication. At Cognitive FX, we use functional neurocognitive imaging (fNCI, a type of fMRI) to determine which regions of your brain have been affected by a concussion. We then use that information to treat our patients with therapies appropriate to their specific needs.
At Cognitive FX, our patients improve by 75% on average after treatment. To see if you are eligible for treatment, sign up for a free consultation.
Medication for Chronic Fatigue, Low Energy, and Motivation
We’ve seen patients on a handful of medications to deal with chronic fatigue and low motivation (in addition to bioidentical hormones, which is covered later in this post). Even a minor head injury can cause major exhaustion. Here are the three we’ve seen patients taking:
- Acetaminophen with Codeine
- Note that this is often for a combination of pain and exhaustion.
- Many patients will increase coffee consumption in the wake of a concussion to compensate for exhaustion. But several studies have shown you may further damage your brain by significantly changing your caffeine intake post-injury. 1 We often recommend that patients coming to our clinic for therapy lower their caffeine intake, and we discuss the best way to accomplish that during the consultation.
- Vitamin B12 injections
- These can be very helpful and may contribute to a patient's recovery.
Medication for Light and Noise Sensitivity
Unfortunately, there’s no medication to improve light and noise sensitivity aside from taking pain medicine to make it less unpleasant. Most patients manage sensitivity with sunglasses and earplugs as needed. Others simply avoid situations in which they would be exposed to bright lights or loud noise.
It’s no way to live, which is why this is one of the many symptoms we treat at our clinic via active rehabilitation. If you want to know more, sign up for a free consultation.
Medications for Vision Problems
Medication for vision problems is usually overlapping with another category. It depends on how your vision is affected. Here are the three categories we see:
- Prism Glasses
- Some optometrists will prescribe prism glasses to correct vision problems after a concussion. If the symptom is caused by a concussion, we advise seeking active rehabilitation before resorting to prism glasses.
- Headache Medicine
- If vision problems are giving patients headaches, they usually combat the problem with headache medicine.
- Medication for Nausea
- If vision problems give patients nausea or cause balance issues, that is usually treated with medication for nausea.
Medication for Blood Pressure Dysregulation
Sometimes, a concussion causes lasting damage to your autonomic nervous system. While it’s treatable with the right therapy, patients can experience hypotension, hypertension, or blood pressure anomalies triggered by a certain activity (like exercise). It could also result in heat or cold sensitivity.
We’ve seen a number of patients taking blood pressure medications, especially those that help anxiety and mood as well as regulate blood pressure. Some examples include:
- Beta-blockers, such as:
- Atenolol (Tenormin)
- Propranolol (Inderal)
- Alpha blockers, such as:
- Clonidine (Catapres)
- Guanfacine (Tenex)
- Calcium channel blockers, such as:
Bioidentical Hormone Replacement
Something many patients don’t realize is that a concussion can cause their hypothalamus and pituitary glands to not function correctly. But recovery time can be anywhere from a few days to never. Hypothalamus or pituitary function cannot be seen with MRI and, if untreated, can lead to problems including thyroid dysfunction or stunted growth.
Treatment of post-concussion syndrome may not resolve hormone dysregulation. A good endocrinologist can work with you to supply the hormones your body isn’t making enough of anymore. Some examples include:
- Growth hormone
- Thyroid hormone, such as:
- Armour Thyroid
- NP Thyroid
- Levothyroxine sodium
- And more.
If you’re overproducing any of these hormones rather than underproducing, then there are typically treatment options for that as well.
Popular Natural Remedies
While we tend to stay out of the supplements conversation, there are a few natural remedies we see patients taking that you may find helpful as well:
- B12 (for energy)
- Curcumin (for inflammation)
- Magnesium (for neural health)
- Melatonin (for sleep).
Whether you’re on multiple medications or just one, it’s important to consider the effect it’s having on your life. Are you straining your liver? What are the medications doing to your body if you have to take them long term? Sometimes the quality of life improvement makes that a risk worth taking. But if you don’t have to rely on medication forever, would you?
If you’re taking medications for concussion symptoms and have not tried active rehabilitation, request a consultation. It’s free to speak with us, and we can help you determine if you’re eligible for treatment. On average, our patients improve by 75% after treatment. Many improve enough to be able to completely stop using the medications they were on.
These are the studies in reference to caffeine intake:
Al Moutaery K, Al Deeb S, Ahmad Khan H, Tariq M. Caffeine impairs short-term neurological outcome after concussive head injury in rats. Neurosurgery. 2003
Li W, Dai S, An J, et al. Chronic but not acute treatment with caffeine attenuates traumatic brain injury in the mouse cortical impact model. Neuroscience. 2008
Yamakawa G. Lengkeek, C., Salberg, S., Spanswick, S., Mychasiuk, R. Behavioral and pathophysiological outcomes associated with caffeine consumption and repetitive mild traumatic brain injury (mTBI) in adolescent rats. PLOS ONE. 2018
About Dr. Mark Allen PhD
Mark D. Allen earned a PhD in Cognitive Science at Johns Hopkins University with post-doctoral training in Cognitive Neuroscience and Functional Neuroimaging at the University of Washington. He has 15 years of research and clinical experience in fMRI, with 22 publications in tier-1 peer-reviewed scientific journals, 3 book chapters, and dozens of presentations at scientific and professional conferences in neuroscience, neuroimaging, and neuropsychology. Having collected and analyzed fMRI data from over 1,000 experimental subjects and over 300 clinically-referred patients, Dr. Allen is a pioneer and expert in the development of fMRI for use in clinical settings.