Open AccessThe use of Amantadine in Cognitive and Behavioral Recovery After Severe Cranioencephalic Trauma: A Systematic Review
Author(s) -
Maria Eduarda Cunha Virgínio,
Lara Hessmann Gonzalez,
Rafael Rodrigues Pinheiro dos Santos,
Ana Carla Mondek Rampazzo,
Gabrielli Algazal Marin,
Mariana Ramos do Nascimento,
Igor Ruan de Araújo Caetano,
Maria Letícia Nogueira,
José Ângelo Favoreto Guarnieri,
Carlos Alexandre Martins Zicarelli
Publication year - 2021
Language(s) - English
Resource type - Conference proceedings
DOI - 10.5327/1516-3180.572
Subject(s) - amantadine , irritability , medicine , systematic review , cochrane library , traumatic brain injury , context (archaeology) , randomized controlled trial , mood , psychiatry , intensive care medicine , cognition , medline , pharmacology , paleontology , political science , law , biology
Background: Traumatic brain injury (TBI) is the main cause of death among individuals between 1 and 44 years of age, and severe TBI is associated with a mortality rate between 30% and 70%. In this context, randomized clinical trials have studied medications to reduce morbidity in severe TBI, one of which is Amantadine. This drug acts on the increase of extracellular dopamine and as an NMDA antagonist. Objectives: Developing a systematic review of systematic reviews to evaluate the efficacy of Amantadine in reducing morbidity in patients with severe TBI. Methodology: The search was conducted in the PubMed, Embase, Cochrane Library, and Portal Regional BVS databases. Results: Eleven systematic reviews were included. The literature review of 7 articles demonstrated the efficacy of treatment with Amantadine in the following clinical aspects after TBI: aggression, irritability, agitation, mood, and attention deficit. On the other hand, one article did not consider the use of Amantadine significantly beneficial, due to increased agitation in critically ill patients, suggesting that there is worsening of the condition in individuals with cognitive, executive, memory, and attention symptoms. Therefore, three studies reported that there was not enough evidence for the use of this drug in patients with severe TBI. Conclusions: The results are heterogeneous. However, this study found good efficacy of Amantadine for cases of agitation/aggression in severe TBI and in cases of diffuse axonal lesion that compromises the glutamate pathways.