THE COMBINED USE OF AMANTADINE AND L-DOPA CARBIDOPA IN THE TREATMENT OF CHRONIC BRAIN INJURY/

The frontal lobes are particularly vulnerable to injury during trauma. The syndrome commonly attributed to frontal lobe dysfunction includes problems with impulsivity, perseveration, disinhibition, amotivation, attention, planning, and problem solving. These symptoms can respond to certain pharmacologic interventions, such as the dopaminergic agent s. The case of a 50-year-old woman who showed persistent frontal dysfu nction 5 years post-injury is described. After treatment with amantadi ne alone, she showed decreased impulsivity and perseveration and impro ved executive function. Further positive response was obtained with th e addition of 1-dopa/carbidopa, with additional improvements in constr uctional praxis, divided auditory attention, and cognitive flexibility . Her improved functioning following treatment demonstrates the potent ial for increasing effectiveness through a combination of dopaminergic agents. No side effects were observed, and the patient maintained gai ns at follow-up. The rationale for using dopaminergic agents alone and in combination is discussed.