Article

Following traumatic brain injury (TBI), individuals may experience
chronic problems with irritability or aggression, which may need treatment to
minimize the negative impact on their relationships, home life, social
interactions, community participation, and employment OBJECTIVE: : To test the a
priori hypothesis that amantadine reduces irritability (primary hypothesis) and
aggression (secondary hypothesis) among individuals greater than 6 months
post-TBI METHODS:: A total of 76 individuals greater than 6 months post-TBI
referred for irritability management were enrolled in a parallel-group,
randomized, double-blind, placebo-controlled trial of amantadine (n = 38) versus
placebo (n = 38). Study participants were randomly assigned to receive amantadine
hydrochloride 100 mg twice daily versus equivalent placebo for 28 days. Symptoms
of irritability and aggression were measured before and after treatment using the
Neuropsychiatric Inventory Irritability (NPI-I) and Aggression (NPI-A) domains,
as well as the NPI-Distress for these domains RESULTS: : In the amantadine group,
80.56% improved at least 3 points on the NPI-I, compared with 44.44% in the group
that received placebo (P = .0016). Mean change in NPI-I was -4.3 in the
amantadine group and -2.6 in the placebo group (P = .0085). When excluding
individuals with minimal to no baseline aggression, mean change in NPI-A was
-4.56 in the amantadine group and -2.46 in the placebo group (P = .046). Mean
changes in NPI-I and NPI-A Distress were not statistically significant between
the amantadine and placebo groups. Adverse event occurrence did not differ
between the 2 groups CONCLUSIONS: : Amantadine 100 mg every morning and at noon
appears an effective and safe means of reducing frequency and severity of
irritability and aggression among individuals with TBI and sufficient creatinine
clearance.

Langue : ANGLAIS