Original ArticlesPharmacologic Treatment of Neurobehavioral Sequelae Following Traumatic Brain InjuryTraeger, Jessica PharmD, BCCCP; Hoffman, Brian PharmD; Misencik, Jennifer PharmD; Hoffer, Alan MD; Makii, Jason PharmD, MBA, FCCM, FNCS, BCCCPAuthor Information Departments of Pharmacy Services (Drs Traeger, Hoffman, Misencik, and Makii) and Neurological Surgery (Dr Hoffer), University Hospitals Cleveland Medical Center, Cleveland, Ohio; and Case Western Reserve University School of Medicine, Cleveland, Ohio (Dr Hoffer). Correspondence: Jessica Traeger, PharmD, BCCCP, Department of Pharmacy Services, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Mather B400, Cleveland, OH 44106 (Jessica.Traeger2@UHhospitals.org). The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article. Critical Care Nursing Quarterly: April/June 2020 - Volume 43 - Issue 2 - p 172-190 doi: 10.1097/CNQ.0000000000000301 Buy Metrics Abstract Traumatic brain injury (TBI) is a leading cause of disability in the United States. With decreasing mortality rates, a higher number of patients are impacted by long-term neuropsychiatric sequelae, such as cognitive deficits, depression, anxiety, and sleep-wake disorders. These sequelae are primarily driven by the disruption of key neurotransmitter homeostasis including dopamine, norepinephrine, serotonin, and acetylcholine. Neurostimulants are centrally acting medications used to assist in restoring these neurotransmitter abnormalities and are pharmacologic options to ameliorate symptoms in post-TBI patients. Examples of neurostimulants include amantadine, selective serotonin reuptake inhibitors, tricyclic antidepressants, central stimulants (ie, methylphenidate), modafinil, and donepezil. Large, well-powered studies have not been performed to validate their use in patients with TBI, leaving uncertainty for these agents' place in therapy. Current practice is driven by consideration of patient-specific factors to select the most appropriate agent. This review provides clinicians with a summary of the available literature on neurostimulants following TBI to guide appropriate usage to help improve patients' symptoms and optimize safety. © 2020 Wolters Kluwer Health, Inc. All rights reserved.