Review of Medications That Reduce Neurological Deficits in Patients With Traumatic Brain Injury.

BACKGROUND

Traumatic brain injury is a leading cause of death and disability worldwide, yet no single drug has proven effective in improving long-term neurological recovery. Understanding the pharmacological efforts made so far is essential for guiding future research and treatment strategies.

PURPOSE: This narrative review aimed to summarize current evidence on medications that reduce neurological deficits in TBI and to highlight emerging therapeutic directions toward neural restoration.

METHODS

A comprehensive literature search was conducted using MEDLINE, Embase, and ClinicalTrials.gov up to May 2025. Studies in English focusing on human trials, meta-analyses, and relevant translational research were included. Articles were appraised for quality using the GRADE and Cochrane risk-of-bias tools, and findings were summarized thematically.

RESULTS

Tranexamic acid given early after injury, nimodipine for traumatic subarachnoid hemorrhage, and short-term anticonvulsants for seizure prevention showed the strongest evidence. Adjunctive drugs such as statins, β-blockers, and SSRIs demonstrated potential benefits in improving vascular, inflammatory, and cognitive outcomes. Newer agents, including minocycline, anakinra, cyclosporine A, and N-acetylcysteine, showed encouraging results in phase II studies. Advances in biomarkers, imaging, and adaptive trials are improving patient selection and precision dosing.

CONCLUSION

Progress in TBI pharmacotherapy is shifting from symptom control toward neurorepair. Continued research integrating biomarkers, affordable therapies, and personalized approaches holds promise for reducing disability and improving recovery after TBI.