Utility of Amantadine Hydrochloride in the Treatment of Post-traumatic Irritability

This study has been completed.
Sponsor:
Collaborator:
U.S. Department of Education
Information provided by:
Carolinas Healthcare System
ClinicalTrials.gov Identifier:
NCT00627250
First received: February 21, 2008
Last updated: March 23, 2010
Last verified: February 2008
  Purpose

The purpose of this study is to determine if amantadine hydrochloride given 100 mg in the morning and at noon is safe and effective in the treatment of mood and behavior changes (i.e. irritability) after sustaining traumatic brain injury.


Condition Intervention
Irritable Mood
Aggression
Traumatic Brain Injury
Drug: Amantadine

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Utility of Amantadine Hydrochloride in the Treatment of Post-traumatic Irritability: A Randomized, Double-Blind, Placebo-Controlled Trial

Resource links provided by NLM:


Further study details as provided by Carolinas Healthcare System:

Primary Outcome Measures:
  • Neuropsychiatric Inventory (Irritability Domain frequency and severity) [ Time Frame: 28 days ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Neuropsychiatric Inventory Irritability and Aggression(Caregiver distress scores) [ Time Frame: 28 days ] [ Designated as safety issue: No ]
  • Neuropsychiatric Inventory Aggression Domain (frequency and severity) [ Time Frame: 28 days ] [ Designated as safety issue: No ]
  • Global Impression of Change rated by clinician, individual with brain injury and caregiver [ Time Frame: 28 days ] [ Designated as safety issue: No ]

Enrollment: 76
Study Start Date: March 2003
Study Completion Date: November 2007
Primary Completion Date: November 2007 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: A
Amantadine 100 mg every morning and 12 noon
Drug: Amantadine
Amantadine 100 mg every morning and 12 noon
Other Name: Symmetrel
Placebo Comparator: B
Placebo tablet every morning and 12 noon
Drug: Amantadine
Amantadine 100 mg every morning and 12 noon
Other Name: Symmetrel

Detailed Description:

Amantadine hydrochloride is a drug used commonly in clinical practice at the Carolinas Rehabilitation for the treatment of mood and behavior changes following traumatic brain injury. Clinical observation suggests that the use of amantadine improves caregiver report of "irritability" though there are no studies to validate this observation. This study investigates the efficacy and side effect profile of amantadine hydrochloride given in 2 doses of 100 mgs each. Subjects are screened during regularly scheduled clinic appointments for the presence of irritability. If they are interested in possible participation in the study, they will be invited to meet with the research coordinator who will obtain informed consent. If the subject meets all the inclusion/exclusion requirements, they will leave clinic with study medication and begin taking the drug the next day. There will be a safety call between day 3 and 5 where the dose may be reduced to once per day. Follow-up assessment occurs at day 14 (by phone) and day 28 (in clinic). At study completion, the subject will have the opportunity to receive a prescription for amantadine as part of ongoing clinical care.

  Eligibility

Ages Eligible for Study:   16 Years to 65 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Closed head injury (defined as brain injury or impaired brain function resulting from externally inflicted trauma without penetrating injury) at least 6 months prior to enrollment.
  • Age at time of enrollment: 16 - 65 inclusive (i.e., on or after 16th birthday, up to day before 66th birthday).
  • Voluntary informed consent of patient and informant.
  • Subject and informant willing to comply with the protocol, & are available for all scheduled clinic visits.
  • Neuropsychiatric Inventory (NPI) Irritability Domain score > 2.
  • Medically and neurologically stable during the month prior to enrollment.
  • If taking antidepressant, anxiolytic, hypnotic, or stimulant medications, no change anticipated in these medications during the month prior to enrollment.
  • No change in therapies or medications planned during the 28-day participation.
  • No surgeries planned during the 28-day participation.
  • Vision, hearing, speech, motor function, and comprehension must be sufficient for compliance with all testing procedures. Ability to interact and verbalize sufficient to participate in assessments.
  • Informant (family member or close friend) who lives with the participant with daily interaction in order to observe occurrences of irritability.

Exclusion Criteria:

  • Patients without a reliable informant
  • Penetrating head injury
  • Injury < 6 months prior to enrollment
  • Inability to interact sufficient for communication with caregiver
  • Acute and rehabilitation records unavailable or incomplete
  • DSM-IV diagnosis of schizophrenia or psychosis
  • Diagnosis of progressive or additional neurologic disease (such as, Alzheimer's disease, parkinson's disease, multi-infarct dementia, other cerebrovascular disorders with dementia, prior cerebrovascular accident, Huntington's disease, olivopontocerebellar atrophy, multisystem atrophy, multiple sclerosis, ALS, CNS tumor, progressive supranuclear palsy).
  • Diagnosis of seizure in the month prior to enrollment.
  • Previous allergy or adverse reaction to study drug
  • Ingestion of amantadine hydrochloride during the month prior to enrollment.
  • Concomitant use of neuroleptic agents or phenelzine
  • Creatinine clearance <60
  • Pregnancy (Beta-HCG performed on all females of child-bearing potential) and lactating females.
  • Clinical signs of active infection
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00627250

Sponsors and Collaborators
Carolinas Healthcare System
U.S. Department of Education
Investigators
Principal Investigator: Flora M Hammond, M.D. Carolinas Rehabilitation
  More Information

Additional Information:
Publications:
Herrman EC, Grabliks J, Engle C, et al. Antiviral activity of L-adamantanamine (amantadine). Proc Soc Exp Biol Med 1960;103:625
Schwab RS, England AC, Postkanzer DC, et al. Amantadine in the treatment of Parkinson's disease. JAMA 1969;208:1168-1170.
Stone TW. Evidence for a non-dopaminergic action of amantadine. Neuroscience Letters 1977;4:343-346.

Responsible Party: Flora Hammond, M.D., Carolinas HealthCare System
ClinicalTrials.gov Identifier: NCT00627250     History of Changes
Other Study ID Numbers: 12-02-06A, H133A020522
Study First Received: February 21, 2008
Last Updated: March 23, 2010
Health Authority: United States: Institutional Review Board

Keywords provided by Carolinas Healthcare System:
Irritability
Aggression
Brain Injury
Amantadine
Irritability and Aggression Due to Traumatic Brain Injury

Additional relevant MeSH terms:
Aggression
Brain Injuries
Wounds and Injuries
Behavioral Symptoms
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases
Craniocerebral Trauma
Trauma, Nervous System
Amantadine
Antiparkinson Agents
Anti-Dyskinesia Agents
Central Nervous System Agents
Therapeutic Uses
Pharmacologic Actions
Antiviral Agents
Anti-Infective Agents
Dopamine Agents
Neurotransmitter Agents
Molecular Mechanisms of Pharmacological Action
Physiological Effects of Drugs
Analgesics, Non-Narcotic
Analgesics
Sensory System Agents
Peripheral Nervous System Agents

ClinicalTrials.gov processed this record on July 22, 2014