The Effectiveness of Amantadine in Improving Consciousness in Patients with Acute Brain Injury

Alireza Rahat Dahmardeh; Aliakbar Keykha; Mehdi Rezvani Amin; Masoum Khoshfetrat

doi:10.18502/aacc.v9i6.14449

Alireza Rahat Dahmardeh Department of Anesthesiology and Critical Care, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran.
Aliakbar Keykha Community Nursing Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.
Mehdi Rezvani Amin Community Nursing Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.
Masoum Khoshfetrat Department of Anesthesiology and Critical Care, Khatam-Al-Anbiya Hospital, Zahedan University of Medical Sciences, Zahedan, Iran.

DOI: https://doi.org/10.18502/aacc.v9i6.14449

Keywords: Acute brain injury; Glasgow coma scale; Amantadine; Impaired consciousness level

Abstract

Background: The improved consciousness level reflects the patient’s recovery following acute brain injury. The medications that can regulate neurotransmitter levels, neural synaptic plasticity, and functional connectivity of consciousness networks might play a crucial role in improving the consciousness status of the patients. Thus, this study aims to evaluate the effectiveness of amantadine in improving consciousness in acute brain injury patients.

Methods: The present quasi-experimental study was performed from 2021 to 2022 after obtaining the necessary permissions from Zahedan University of Medical Sciences, Iran. Eighty patients with acute brain injury who met the study inclusion criteria were recruited and randomized into amantadine and placebo groups. The amantadine group was given a daily dose of 100 mg amantadine tablets, while the placebo group received a gavage of amantadine-like placebo tablets twice daily for 14 days. The consciousness level of patients was measured daily until the outcome (ICU discharge or expiration) was established. Eventually, a comparative data analysis was conducted to determine amantadine's efficacy in enhancing consciousness, reducing mechanical ventilation time, and improving patient outcomes.

Results: The mean GCS score in the amantadine group was 5.5±1.4 on admission and 11.9±3.7 at the end of the study, compared to 6.6±1.5 on admission and 11.8±3 at the end of the study, for the placebo group (p=0.154 and p=0.211, respectively). The mean duration of mechanical was 28.87±11.34 days in the amantadine group and 24.13±14.93 days in the placebo group (P=0.329). Twenty-four patients in the amantadine group were discharged from ICU, and 16 were expired. For the placebo group, 21 patients were discharged from ICU, while 16 were expired (p=0.221). No statistically significant difference was found in any of the measured variables between the two groups.

Conclusion: The results demonstrate that amantadine administration had no statistically significant impact on improving consciousness status and clinical outcomes and reducing mechanical ventilation time in acute brain injury patients.