Prescribing Patterns of Amantadine During Pediatric Inpatient Rehabilitation After Traumatic Brain Injury: A Multicentered Retrospective Review From the Pediatric Brain Injury Consortium.
Matthew J McLaughlin, Eric Caliendo, Ryan Lowder and 10 others
PMID 34320554WHAT IT FOUND
Amantadine was prescribed to 21% of children after traumatic brain injury, mostly those with disorders of consciousness.
Dosing varied widely, from 0.7 to 13.5 mg/kg/day, with no standard protocol. Adverse effects occurred in 16% of treated patients, but no serious events were reported.
Key findings
01Patients in disorders of consciousness were significantly more likely to receive amantadine (45%) than those with higher cognitive functioning (14%).
02There was substantial variability in dosing, with lowest recorded doses ranging from 0.7 to 8.2 mg/kg/day and highest recorded doses ranging from 1.1 to 13.5 mg/kg/day.
03Adverse effects were reported in 16% of patients receiving amantadine, most commonly nausea/abdominal discomfort and agitation, with no serious adverse events.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
This was a retrospective chart review, so data on adverse effects and dosing relied on clinical documentation, which may be incomplete or inconsistent. The study describes prescribing patterns but cannot determine if amantadine improved patient outcomes because it lacked a control group and standardized outcome measures. Cognitive state classification varied by site and was not assessed with a single standardized tool across all patients. The sample size for patients receiving amantadine (49) is relatively small, limiting the precision of adverse effect rates.
Declared interests
The authors reported no conflicts of interest.
The easy way to misread this
Do not interpret the frequent prescribing of amantadine as evidence that it improves recovery. This study only describes what clinicians are currently doing, not whether the drug works. The wide variation in dosing and lack of outcome data mean there is no established standard of care for amantadine in pediatric TBI.