Abstract
The development of postconcussion syndrome after traumatic brain injury can result
in a wide range of potentially debilitating symptoms that includes headaches, cognitive
dysfunction, and mood disorders. Unfortunately, data on helpful medications are quite
limited, particularly on the treatment of persistent headaches attributed to trauma.
This retrospective medical record review used data collected from patients with a
diagnosis of postconcussion syndrome in Mayo Clinic's Neurology and Physical Medicine
and Rehabilitation outpatient clinics to evaluate the response of postconcussive symptoms
to amantadine. A complete trial of amantadine was defined as 100 mg twice per day for 2 months. Thirty-three patients were prescribed
amantadine for postconcussive syndrome after traumatic brain injury. One-third of
patients discontinued the medication because of adverse effects. However, posttraumatic
headaches were improved in 80% of patients who completed a full trial of amantadine.
Surprisingly, patients had improvement in headaches even if the medication was prescribed
years after the initial trauma. Little improvement was noted in other symptoms such
as poor memory, dizziness, and personality changes. Although additional research is
certainly needed, amantadine may be a reasonable medication to consider for the treatment
of persistent headaches attributed to trauma, even if the initial injury is remote.
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References
- Amantadine effect on perceptions of irritability after traumatic brain injury: results of the Amantadine Irritability Multisite Study.J Neurotrauma. 2015; 32: 1230-1238
- Placebo-controlled trial of amantadine for severe traumatic brain injury.N Engl J Med. 2012; 366: 819-826
- Post-concussive syndrome: a focus on post-traumatic headache and related cognitive, psychiatric, and sleep issues.Curr Neurol Neurosci Rep. 2016; 16: 100
Article Info
Footnotes
Potential Competing Interests: Dr Cutrer is a member of the advisory board of Alder Biopharmaceuticals and Supernus Pharmaceuticals and receives royalties from UpToDate. The other authors report no competing interests.
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