From the Research
Amantadine should not be used as a primary treatment for cognitive recovery in patients with traumatic brain injury (TBI) due to lack of strong evidence supporting its efficacy, as shown in the most recent and highest quality study 1. The use of amantadine in TBI management has been a topic of debate, with some studies suggesting potential benefits in cognitive recovery, while others have found no significant improvement. However, the most recent and highest quality study, a multi-site, randomized, controlled trial published in 2018 1, found that amantadine did not positively impact cognition in chronic TBI patients. This study's findings are consistent with the need to prioritize morbidity, mortality, and quality of life as outcomes in TBI management.
Some key points to consider when evaluating the role of amantadine in TBI management include:
- The lack of strong evidence supporting its efficacy in improving cognitive function, as demonstrated by the 2018 study 1
- The potential for amantadine to impede cognitive processing in the first 28 days of use, as found in the same study 1
- The need for regular monitoring of cognitive function and potential adverse effects, such as insomnia, anxiety, and gastrointestinal disturbances
- The importance of considering alternative treatment options that have stronger evidence supporting their use in TBI management
It is essential to note that while some older studies, such as those published in 2015 2 and 2014 3, suggested potential benefits of amantadine in TBI management, these findings are not supported by the most recent and highest quality evidence. A 2022 meta-analysis 4 found that amantadine may improve cognitive function in TBI patients, but the certainty of the evidence was low, and further research is needed to confirm these findings. A 2024 review 5 highlighted the potential mechanisms of action of amantadine in TBI, but also emphasized the need for well-controlled clinical studies to ultimately confirm its utility.
In conclusion, the most recent and highest quality evidence does not support the use of amantadine as a primary treatment for cognitive recovery in TBI patients. Therefore, amantadine should not be used as a first-line treatment for TBI, and alternative options should be considered.