Concussion Treatments and Medications

A concussion is a mild traumatic brain injury (TBI) that often occurs due to a strong blow to the head, which can cause the brain to rapidly move within the skull. The risk of getting one is higher in people who experience falls, contact sports, and car accidents. Symptoms may include a headache, dizziness, nausea, confusion, trouble sleeping, and even mood changes. Concussions can last anywhere from a few days to a month or more. Treatment involves resting, with some medications like acetaminophen being used to help manage symptoms. 

How is a concussion diagnosed?

A healthcare provider can diagnose a concussion based on a person’s symptoms and medical history. They’ll likely ask about the injury or event that caused the symptoms, how severe the symptoms are, and whether the person has a history of past concussions. An evaluation may include:

• A neurological exam to test balance, coordination, vision, and reflexes

• A cognitive test to check for any problems with memory or thinking

• A screening for any mood or sleep changes

• A physical exam or other tests for more severe problems, such as a skull fracture or brain bleeding

Blood tests and imaging exams are not recommended for all cases unless a more serious injury has occurred. For athletes, a professional may assess a concussion with the Sport Concussion Assessment Tool 6 (SCAT6). If symptoms worsen after a couple of days and include a worsening headache, vomiting, or seizures, it’s important to get emergency medical attention. 

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Concussion treatment options

There is no single medication or procedure that can cure a concussion. In most cases, a concussion will heal on its own over time. However, some strategies may help improve recovery and manage symptoms. The first-line treatment for a concussion is mental and physical rest for 24 to 48 hours after the injury, followed by gradually returning to normal activities. Most people recover from a concussion within two to four weeks, depending on the severity. Certain medications may help with symptoms like headache, nausea, and dizziness. A healthcare provider will look at a person's overall health and symptoms before recommending a treatment plan.

Types of concussion medication

No medication can speed up the healing of a concussion since the brain heals on its own over time. However, some medications may be used to help manage symptoms while the brain recovers.

Pain relievers

For most people with a concussion, a common symptom is a headache that can feel like a migraine. Within the first few hours after the injury, Tylenol (acetaminophen) is the recommended pain reliever. It’s best to avoid NSAIDs like aspirin and ibuprofen, since taking these may increase the risk of bleeding, which could worsen a head injury. If there is no bleeding confirmed after the injury, an NSAID may be used later on, especially if headaches still occur.

Vestibular suppressants

Dizziness and nausea are other common symptoms of a concussion. Medicines for motion sickness, also called vestibular suppressants, can help reduce signals in the inner ear that cause these symptoms. Options include meclizine and dimenhydrinate, often found in Dramamine products, as well as the anticholinergic scopolamine patch. For more serious cases of nausea, Zofran (ondansetron) may be prescribed.

Antidepressants

For many people, a concussion also comes with sleep problems and mood changes, including depression. Tricyclic antidepressants, SRIs (selective serotonin reuptake inhibitors), or SNRIs (serotonin and norepinephrine reuptake inhibitors) may be prescribed to help with mood or sleep changes.

Stimulants

For serious cases of concussions that cause long-term effects on attention and concentration, stimulants may sometimes be prescribed. Studies suggest a stimulant like methylphenidate or dextroamphetamine can help improve mental fatigue and other cognitive symptoms. 

Triptans

For concussions that cause migraines, triptans like sumatriptan and rizatriptan can help manage symptoms like throbbing pain, sensitivity to light, and nausea. However, these medications are reserved for severe cases, especially when these headaches persist for weeks or months.

Over-the-counter concussion medicine

Many of the recommended medications for concussion symptoms can be found over the counter. For example, acetaminophen is widely accessible over the counter and can be used in the first few days of a concussion. Dimenhydrinate and meclizine are also found over the counter under the brand name Dramamine. In addition, melatonin is a commonly used supplement that may help with short-term sleep problems.

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