A small controlled trial reported attention-related benefits from lisdexamfetamine in selected children with persistent symptoms after traumatic brain injury. Improved attention testing did not establish that the medication repaired the underlying injury.
Tramontana and colleagues enrolled 20 children aged 10–16 in a 12-week randomized double-blind placebo-controlled dose-titration crossover trial. Sixteen completed it. Most injuries were characterized as mild, but attention and other post-concussion symptoms had persisted for two to 29 months. Assessments included neuropsychological testing, parent ratings and weekly safety monitoring.
Benefits were reported on formal sustained-attention testing and parent-rated attention, behavioral control and related outcomes. One child withdrew after a mild anxiety reaction on lisdexamfetamine. The small trial therefore offered evidence for selected symptom outcomes, alongside a tolerability observation. Parent reports and standardized tests are complementary; neither demonstrates improvement in every cognitive domain or recovery of injured tissue.
The carefully selected sample and limited number of completers constrain precision and generalization. Results in persistent pediatric post-injury symptoms cannot be assumed to apply to an acute concussion, severe injury or every child with attention difficulty. A crossover comparison can improve control of between-person variation, but it does not provide long-term outcome surveillance. The study did not establish prevention of later disability, return-to-play readiness or safety for complex activities. Lisdexamfetamine delivers dexamphetamine; it is not methamphetamine, and a therapeutic response cannot identify the cause of attention symptoms by itself. The supported conclusion concerns short-term treatment effects in this clinical context, with injury repair and durable functional recovery left for separate investigation.
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