N OF 1 STUDY - AMANTADINE FOR THE AMOTIVATIONAL-SYNDROME IN A PATIENTWITH TRAUMATIC BRAIN INJURY

Severe amotivation, apathy, and abulia, significantly retard rehabilit ation following traumatic brain injury. Preliminary, uncontrolled rese arch has suggested possible benefit with amantadine for this behaviour al syndrome. This N of 1, double-blind, placebo-controlled study emplo yed amantadine 100 mg three times daily in one such patient. Therapist s and nurses completed inventories scoring efforts towards initiation of therapeutic activities during each session, progress in therapy, an d participation in therapy. Four treatment periods (two active medicat ion, two placebo), of 2 weeks duration, were completed. Across four th erapists, and for both treatment pairs, the average effect score incre ased from 0.86 on placebo to 1.74 on amantadine (possible range 0-6, 3 = 'average'). There were no side-effects. The study suggests possible benefit with amantadine for patients with amotivational syndrome afte r traumatic brain injury; a randomized clinical trial appears warrante d and required.