Amantadine Continuation After Hospital Discharge for Acute Stroke Requiring Inpatient Rehabilitation: A Long-term Follow-up Study.
Haley R Torr, Sara Penrod, Jennifer Cote and 7 others
PMID 40678286WHAT IT FOUND
In 28 stroke patients continuing amantadine into rehab, dosing varied widely but appeared safe.
Most patients improved in mobility and speech, yet confusion and agitation often emerged when doses were reduced, not increased. This offers no guidance on optimal dosing or timing.
Key findings
01Amantadine dosing during rehabilitation was highly variable, with most patients receiving 100 mg twice daily upon admission, and doses were frequently decreased rather than increased.
02Adverse effects such as confusion, agitation, and lethargy were associated with dose reductions, whereas dose increases were not linked to adverse events.
03Among patients whose dose was adjusted, 17 of 19 showed improvement in assistance levels for ambulation, daily activities, and language.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study was retrospective and observational, relying on existing medical records and clinician attribution, which introduces potential bias. The cohort was very small (28 patients) and from a single institution, limiting generalizability. No control group was used, so it is impossible to determine if improvements were due to amantadine, rehabilitation, or natural recovery. There was no standardized protocol for amantadine administration, leading to highly variable dosing that cannot be compared across patients. Adverse events were identified from notes, not systematic screening, so mild or unrecorded effects may have been missed.
Declared interests
The investigators have no financial or nonfinancial disclosures to make in relation to this project.
The easy way to misread this
Do not interpret the 90% improvement rate in patients with dose changes as evidence that amantadine causes recovery. This was an uncontrolled observational study where patients also received intensive rehabilitation, and the improvements may reflect natural recovery or therapy effects rather than the medication.