Drug Seems to Speed Recovery After Traumatic Brain Injury
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Study suggests amantadine may gently awaken patients in vegetative, minimally conscious states -- A drug that's typically used to treat the flu and Parkinson's disease appears to speed recovery in traumatic brain injury patients, a new study indicates. Traumatic brain injury (TBI) victims who weren't fully conscious and were discharged to rehabilitation facilities after hospitalization were given amantadine hydrochloride. The drug is already given "off-label" to such patients, but if and how much it helps has remained unclear. While taking the drug, the patients given amantadine scored better on behavioral tests that measure how well the brain is functioning compared to a group of patients given a placebo, researchers report in the March 1 issue of The New England Journal of Medicine.
"Amantadine appeared to increase the rate of recovery compared to placebo. Patients got better faster while they were on the drug," said study co-author Joseph Giacino, director of rehabilitation neuropsychology at the Spaulding Rehabilitation Hospital, in Boston, and an associate professor in the department of physical medicine and rehabilitation at Harvard Medical School.
Study co-author Dr. John Whyte, director of the Moss Rehabilitation Research Institute at Albert Einstein Healthcare Network, in the Philadelphia area, said previous observational studies had suggested amantadine improved the rate of recovery. While the medicine is already commonly prescribed off-label to treat people suffering from prolonged disorders of consciousness, he said this is the first placebo-controlled trial of the drug in patients who were either in a vegetative state (wakeful but not aware) or a minimally conscious state (able to track with their eyes).
"There were many hypotheses out there about what this drug should do, but there was very little data to support or refute those hypotheses," Whyte explained.
For the study, 184 patients from 11 medical centers in three countries were enrolled. They had all suffered a TBI within the previous one to four months. Half received amantadine while the other half were given a placebo for the first four weeks of the six-week study. Both groups were followed up for two additional weeks, Whyte said. The researchers used the Disability Rating Scale (DRS) to monitor patients' progress during the treatment and follow-up period. The test measures eye opening, verbal ability and motor response, among other functions, Giacino said.
"During the four-week treatment period, recovery was significantly faster in the amantadine group than the placebo group," said Giacino.
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