Amantadine enhancement of arousal and cognition after traumatic brain injury

The Annals of Pharmacotherapy
Elizabeth SawyerMartin J Ohlinger

Abstract

To determine the role of amantadine therapy for early arousal and improved cognition in traumatic brain injury (TBI). Literature was accessed through MEDLINE (1950-August 2007) using the MeSH terms amantadine, brain injuries, cognition, and arousal. PubMed (through August 2007) terms included amantadine, traumatic brain injury, and cerebral injury. All studies of amantadine (used <6 mo after injury) for enhancement of arousal or cognition in patients with TBI were reviewed. Many cases of TBI are associated with frontal lobe injury. As a dopamine agonist, amantadine is thought to be involved in frontal lobe stimulation. Two case reports, 3 retrospective studies, and 2 randomized, double-blind, controlled trials of amantadine therapy for early arousal in TBI were identified and reviewed. Limitations of the available studies include open design, retrospective design, and heterogeneous brain injury types. Results have been inconsistent between studies, largely due to variability in designs, heterogeneity in patient populations, time following injury, and use of numerous different outcome measures. Despite these limitations, improvements in arousal and cognition, as documented by the Glasgow Coma Scale and other measures, have been ...Continue Reading

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