When do you consider using stimulants in patients with cognitive impairments secondary to traumatic brain injury?

Perhaps most importantly, prescribing medication to address cognitive difficulties conveys hope to TBI patients that even if they have suffered structural brain damage, they can improve. Though the improvement may be fairly small, it can have important implications for better general functioning. We have to convey realistic expectations of how much they are likely to benefit, so as not to cause feelings of hopelessness and failure. Following people over time is also helpful in maintaining hope for recovery, which may develop much more slowly than people think it will.

I consider first-line treatment in TBI especially with lethargy.