Objectives: To evaluate feasibility and efficacy of amantadine as therapeutic option for patients with acute traumatic brain injury (TBI) aiming to improve their neurobehavioral functions.
Patients & Methods: ۲۸٤ TBI patients admitted to surgical ICU were clinically evaluated for injury severity using Injury Severity Score (ISS), Disability Rating Scale (DRS) and Coma Recovery Scale–Revised (CRS-R). Patients were randomly allocated into Control group received placebo and Study group received amantadine hydrochloride ۱۰۰ mg twice daily for ٤ weeks. Study outcomes included frequency of responders judged by evaluation of DRS and CRS-R scores at end of ۲nd and ٤th week of treatment and the frequency and extent of regression of both scores ۲-wk after amantadine stoppage.
Results: ٥٦ patients died during ICU stay and ۱۱ patients developed amantadine-related side effects and were excluded from the study. The ۲۸-day
neurobehavioral outcome of patients received amantadine was significantly better than control patients as manifested by rapid improvement of DRS with significantly higher number of patients had improved score and significantly higher frequency of patients had higher CRS-R score in study than control group. Outcome of amantadine was manifest after the ۲nd wk and peaked at the ٤th wk of starting therapy with
significant difference between both groups. At end of ۲-wk amantadine therapy
stoppage, patients of study group showed slight regression of their improved scores to an extent which is significant versus scores determined at the end of the ٤th wk of
therapy, despite being still significantly better than scores of control patients determined at the ٦th wk of ICU admission.
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Conclusion: Amantadine supplemental therapy to acute TBI patients is feasible and safe option that allowed rapid resumption of functional activities and reduction of injury-induced disabilities than the reliance on conventional therapy alone. |
