Author

Year

Country

Study Design

Sample Size

Beers et al.

(2005)

USA

RCT

PEDro=5

N_I=37, N_F=27

Population: TBI; Age Range=6-16yr; Gender: Male=24, Female=13; Mean Time Post Injury=0.9yr; Severity: Mild=11, Moderate=10, Severe=16.

Intervention: Patients were randomized to receive amantadine or to a usual care control group. Amantadine was administered 2x/d for 12 wk. Dosages were determined by age and weight with those aged 6-9yr and weighing less than 40 kg receiving a maximum of 150 mg/d and those aged 10-16yr and more than 40 kg receiving a maximum of 200 mg/d. Patients were contacted daily for the first week then 1 day/wk for the remaining 11 wk.

Outcome Measure: Behavior Rating Inventory of Executive Function – Global Executive Composite (BRIEF-GEC), BRIEF -Behavioral Regulation Index (BRIEF-BRI), BRIEF – Metacognition Index (BRIEF-MI), Tower of London Test (ToL), Wisconsin

Card Sorting Test (WCST), Number of Side Effects.

1.        BRIEF-BRI, BRIEF-GEC and BRIEF-MI scores for patients treated with amantadine all significantly improved from baseline to post-treatment compared to the control group (p=0.007, p<0.000, p<0.000 respectively).

2.        No significant differences between groups on the ToL and WCST (both p>0.050).

3.        Six patients experienced side effects including nausea, constipation and vomiting for <2 d. One patient experienced daily side effects for 1 wk and withdrew. No side effects were reported at 6-12 wk in the remaining participants.

Green et al.

(2004)

USA

Case Control

N=118

Population: TBI; Amantadine Group (n=54): Mean Age=11.8yr; Gender: Male=33, Female=21; Mean GCS=5.6. Control Group (n=64): Mean Age=10.3yr, Gender: Male=47, Female=17; Mean GCS=7.4.

Intervention: Participants that were admitted to the hospital for longer than 48 hr and administered amantadine were retrospectively analyzed. Patients who received amantadine were compared to a control group which did not receive a neurostimulant.

Outcome Measure: Glasgow Coma Scale (GCS), Length of Stay (LOS), Post-traumatic Amnesia (PTA) duration, Ranchos Los Amigos (RLA), Complications.

1.        Significant difference between groups for initial GCS and admission RLA scores (p<0.010).

2.        Side effects from amantadine but not controls included: aggression, nausea/vomiting, hallucinations, and delusions.

3.        Amantadine group had significantly greater increase in RLA during admission than controls (p<0.010), but not LOS or PTA duration (p>0.050).

4.        A subjective review of available charts (n=29) reveal improvement in alertness, initiation, verbalizations, and agitation.