Personality Change Due to TBI: Affective Instability
and Rage Subtypes | Personality Change Due to TBI: Disinhibited, Paranoid,
and Apathetic Subtypes | Attention-Deficit/Hyperactivity Disorder | Depression
There are no studies of treatment of children with PC, therefore
the following guidelines are anecdotal. Clinically, it is important
to differentiate the subtypes because treatment approaches are different.
The affective instability and aggressive types co-occur frequently
(Max et al. 2001) and respond similarly to treatment. Mood-stabilizing
medications such as carbamazepine and valproic acid can be particularly
effective when combined with a behavior modification program targeting
aggression. Adding a selective serotonin reuptake inhibitor (SSRI)
to a mood stabilizer may be helpful as well. This may be counterintuitive
for clinicians who work with children because of the well-known
side effects of irritability and restlessness with SSRIs. Adults
with affective instability (e.g., pathological laughter and pathological
crying) have responded well to SSRIs (Robinson et al. 1993).