Amantadine to enhance readiness for rehabilitation following severe traumatic brain injury.
OBJECTIVE
To evaluate the association between amantadine and recovery of consciousness from prolonged traumatic coma.


METHODS
A retrospective cohort study.


METHODS
Subjects included 123 adults with severe traumatic brain injury (TBI) admitted over a 10-year period who remained in coma despite becoming medically stable.


METHODS
Cases received 100-200 mg of amantadine twice daily.


RESULTS
46.4% (13/28) of cases emerged from coma compared to 37.9% (36/95) of controls (p = 0.42). Somatosensory evoked potential (SSEP) was the only significant predictor of emergence from coma (p = 0.02), while SSEP, age and Glasgow Coma Score (GCS) significantly predicted time to emerge from coma (p < 0.05).


CONCLUSIONS
Although the study and its design do not support the view that amantadine has an effect on recovery of consciousness; it remains safe, inexpensive and has few side effects. The lack of treatment alternatives and anecdotal support for its use may warrant further study. Prospective controlled trials would yield more definitive results.
Hughes
Shari
S
Sunnybrook & Women's College Health Sciences Centre, Toronto, ON, Canada. shari.hughes@sw.ca
Colantonio
Angela
A
Santaguida
P Lina
PL
Paton
Thomas
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000547:Amantadine / Q000627:therapeutic use*; D001930:Brain Injuries / Q000188:drug therapy* / Q000534:rehabilitation; D015331:Cohort Studies; D020207:Coma, Post-Head Injury / Q000188:drug therapy*; D015259:Dopamine Agents / Q000627:therapeutic use*; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012189:Retrospective Studies
D015259:Dopamine Agents; D000547:Amantadine