Effect of Amantadine on Agitation in Critically Ill Patients With Traumatic Brain Injury.

Abstract

OBJECTIVE:

This study aimed to compare the presence of agitation in traumatic brain injury patients treated with amantadine with those not treated with amantadine in the intensive care unit (ICU).

METHODS:

This was a retrospective cohort study conduced in a trauma ICU of a tertiary care institution in the United States. Patients who received amantadine were compared with patients who did not receive amantadine. The primary outcome measure was the presence of agitation, defined as the Richmond Agitation Sedation Scale score of +2 or higher. Secondary comparisons included haloperidol use, benzodiazepine use, opioid use, and ICU length of stay.

RESULTS:

A total of 139 patients were included in the study cohort (70 patients in the amantadine group, 69 patients in the no-amantadine group). There were more patients who had agitation in the amantadine group (38% vs 14%, P = 0.018). Patients who received amantadine received more opioids in fentanyl equivalents (10.3 [interquartile range {IQR}, 6.3-20.4] μg/kg vs 7.4 [IQR, 2.1-12.6] μg/kg, P = 0.009) and had a longer ICU length of stay (4.5 [IQR, 3-10] days vs 3 [IQR, 2-5] days, P = 0.010). Haloperidol use and benzodiazepine use were similar between groups.

CONCLUSIONS:

The early use of amantadine after traumatic brain injury may increase the risk of agitation. This could increase opioid consumption and ICU length of stay.

• Authors: Jawaher A Gramish, Brian J Kopp, Asad E Patanwala
• Journal: Clinical neuropharmacology (Clin Neuropharmacol) 2017 Sep/Oct Vol. 40 Issue 5 Pg. 212-216 ISSN: 1537-162X [Electronic] United States
• PMID: 28816834 (Publication Type: Journal Article)

Chemical References

• Analgesics, Opioid
• Dopamine Agents
• Benzodiazepines
• Amantadine
• Haloperidol

Topics

• Adult
• Akathisia, Drug-Induced (drug therapy)
• Amantadine (adverse effects)
• Analgesics, Opioid (therapeutic use)
• Benzodiazepines (therapeutic use)
• Brain Injuries, Traumatic (complications, drug therapy)
• Critical Illness
• Dopamine Agents (adverse effects)
• Drug Utilization (statistics & numerical data)
• Female
• Haloperidol (therapeutic use)
• Humans
• Intensive Care Units (statistics & numerical data)
• Length of Stay (statistics & numerical data)
• Male
• Middle Aged
• Psychomotor Agitation (complications, drug therapy)
• Retrospective Studies
• Young Adult