title: Amantadine for patients with severe traumatic brain injury: a critically appraised topic.
abstract: BACKGROUND
  Research into traumatic brain injury (TBI) has increased significantly. Diagnostic testing and therapeutics for patients with severe TBI are 2 areas on which there is increasing focus. Amantadine hydrochloride is one treatment considered to have potential therapeutic value in this patient population.
  
  
  OBJECTIVE
  The objective was addressed through the development of a structured critically appraised topic. This included a clinical scenario, structured question, literature search strategy, critical appraisal, results, evidence summary, commentary, and bottom-line conclusions. Participants included consultant and resident neurologists, a medical librarian, clinical epidemiologists, and content experts in the disciplines of neurocritical care and physical medicine and rehabilitation.
  
  
  RESULTS
  A multicenter, placebo-controlled, double-blind, randomized controlled trial was selected for review. The trial compared the rate of recovery, as determined by the overall Disability Rating Scale score, in a total of 184 patients with severe TBI. Patients were randomized to either receive amantadine (87) or visually identical placebo (97) over the 4-week study interval. The rate of recovery, as measured by the Disability Rating Scale, was found to be greater in the treatment arm as compared with the placebo arm (difference in slope -0.24 points/wk, P=0.007) over the 4-week treatment interval.
  
  
  CONCLUSIONS
  The results from this study demonstrated that amantadine hydrochloride accelerates recovery in patients with severe TBI.
authors.affiliation: Departments of *Neurology †Physical Medicine and Rehabilitation §Library Services, Division of Education Administration, Mayo Clinic ‡Department of Pediatric Neurology, Neurocritical Care, Phoenix Children's Hospital, Phoenix, AZ.
authors.forename: Scott D
authors.initials: SD
authors.lastname: Spritzer
authors.forename: Carolyn L
authors.initials: CL
authors.lastname: Kinney
authors.forename: John
authors.initials: J
authors.lastname: Condie
authors.forename: Kay E
authors.initials: KE
authors.lastname: Wellik
authors.forename: Charlene R
authors.initials: CR
authors.lastname: Hoffman-Snyder
authors.forename: Dean M
authors.initials: DM
authors.lastname: Wingerchuk
authors.forename: Bart M
authors.initials: BM
authors.lastname: Demaerschalk
mesh_terms: D000293:Adolescent; D000547:Amantadine / Q000627:therapeutic use*; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use*; D001930:Brain Injuries / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D016239:MEDLINE / Q000706:statistics & numerical data; D008297:Male; D015337:Multicenter Studies as Topic; D016032:Randomized Controlled Trials as Topic; D015599:Trauma Severity Indices
chemical_list: D018712:Analgesics, Non-Narcotic; D000547:Amantadine