Table: Amantadine and Behavioural Disorders in Children with ABI

Author/Year/ Country/
Study Design/ PEDro

Methods

Outcomes

Beers et al.
(2005)
USA
RCT
PEDro=5
NI=37, NF=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 12wk. Dosages were determined by age and weight with those aged 6-9yr and weighing less than 40kg receiving a maximum of 150mg/d and those aged 10-16yr and more than 40kg receiving a maximum of 200mg/d. Patients were contacted daily for the first week then 1d/wk for the remaining 11wk.  
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>0.05).
  3. Six patients experienced side effects including nausea, constipation and vomiting for <2d. One patient experienced daily side effects for 1wk and withdrew. No side effects were report at 6-12wk.
Green et al. (2004)
USA
Case Control
N=118
Population: TBI; Amantadine (n=54): Mean Age=11.8yrs; Gender: Male=33, Female=21; Mean GCS=5.6. Controls (n=64): Mean Age=10.3, Gender: Male=47, Female=17; Mean GCS=7.4.
Intervention: Participants that were admitted to the hospital for longer than 48 hours and administered amantadine were retrospectively analyzed. Control group 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<0.01).
  2. Side effects from amantadine but not controls include: aggression, nausea/vomiting, hallucinations, and delusions.
  3. Amantadine group had significantly greater increase in RLA during admission than controls (p<0.01), but not LOS or PTA duration (p>0.05).
  4. A subjective review of available charts (n=29) reveal improvement in alertness, initiation, verbalizations, and agitation.

PEDro = Physiotherapy Evidence Database rating scale score (Moseley et al., 2002).