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DISTRACTIBILITY
Wandering attention is extremely common following a TBI. This shows up in a variety of ways. The patient can no longer perform complex activities in a spontaneous manner, and must go step by step through a sequence, during which any distraction (the ringing of the phone or a person asking him a question) will throw him completely off course. The same patient may lose his focus when two people are speaking to him at the same time. He may have trouble remaining focused while reading, drifting off every couple of minutes, and needing to go back to the beginning of the text over and over. He may forget where he is driving, and realize too late that he has passed his intended exit. Various medications are now being tried out with TBI patients to improve distractibility and increase sustained attention. One of them is Ritalin, the same drug used with children who have ADHD. Some adult TBI patients say Ritalin has helped significantly. Others found it useless, and were bothered by side effects. Some people take Melatonin to improve concentration, but a recent randomized, double-blind trial published in the American Journal of Psychiatry (1999; 156:1392-1396) found subjects who took placebo rated their level of concentration the same.