Amantadine may be effective treatment for headaches after traumatic brain injury
Posttraumatic headaches improved for 80% of patients who took amantadine for 2 months after having postconcussion syndrome, according to a study published in Mayo Clinic Proceedings.
“In previous studies, amantadine has been used to treat various symptoms in the setting of traumatic brain injury, ranging from certain aspects of frontal lobe disorders including impulsiveness and disinhibition to trying to increase the pace of functional recovery in the acute setting,” Ivan D. Carabenciov, MD, of the department of neurology at the Mayo Clinic in Rochester, Minnesota, and colleagues wrote. “To our knowledge, amantadine’s effects on posttraumatic headaches have not been studied. In current clinical practice, medications such as amitriptyline, nortriptyline and topiramate are commonly used as first-line therapies.”
To assess the effectiveness of amantadine on posttraumatic headaches, researchers conducted a retrospective medical record review of data collected from 33 patients (64% men; mean age 35 years) who had been diagnosed with postconcussive syndrome in Mayo Clinic’s Neurology and Physical Medicine and Rehabilitation outpatient clinics from January 2007 to January 2017.
Beginning more than 1 month after traumatic brain injury, patients were prescribed 100 mg of amantadine twice a day for 2 months.
Researchers used the medical records to collect information regarding a variety of postconcussion syndrome symptoms including headaches, inattention, memory loss, irritability, personality changes and subjective dizziness. An improvement in each symptom was evaluated based on the physician’s documentation, which was itself based on the patient’s report.
Patients were followed for a mean of 9 months.
Researchers found that, of patients who completed a full trial of amantadine, 80% had improvement in their headaches and improvement was still evident even if the medication was prescribed years after the initial trauma.
No significant improvements were seen for the other symptoms assessed.
“Further studies are certainly necessary, but our experience suggests that amantadine may be a reasonable medication to prescribe for postconcussion headaches if patients are refractory to other medications,” the researchers wrote. “We therefore propose that a complete amantadine trial of 100 mg twice per day for 2 months is considered as a potential option for patients with significant postconcussive headaches.” – by Melissa J. Webb
Disclosures: Carabenciov reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.