Consciousness Recovery in Traumatic Brain Injury: A Systematic Review Comparing Modafinil and Amantadine.

IF 0.8 4区医学 Q4 CLINICAL NEUROLOGY

Clinical Neuropharmacology Pub Date : 2023-11-01 Epub Date: 2023-10-19 DOI:10.1097/WNF.0000000000000577

Ali Seifi, Sina Hassannezhad, Reza Mosaddeghi-Heris, Arash Haji Kamanaj Olia, Ali Adib, Shaheryar Hafeez, Colleen Barthol

{"title":"Consciousness Recovery in Traumatic Brain Injury: A Systematic Review Comparing Modafinil and Amantadine.","authors":"Ali Seifi, Sina Hassannezhad, Reza Mosaddeghi-Heris, Arash Haji Kamanaj Olia, Ali Adib, Shaheryar Hafeez, Colleen Barthol","doi":"10.1097/WNF.0000000000000577","DOIUrl":null,"url":null,"abstract":"Objectives: Acute traumatic brain injury is one of the most common causes of death and disability. Reduction in the level of consciousness is a significant complication that can impact morbidity. Glasgow Coma Scale (GCS) is the most widely used method of assessing the level of consciousness. Neurostimulants such as amantadine and modafinil are common pharmacologic agents that increase GCS in patients with brain trauma. This study aimed to compare the effectiveness of these 2 drugs.Methods: This systematic review obtained articles from Google Scholar, PubMed, Scopus, Embase, and MEDLINE databases. Extensive searches were conducted separately by 4 individuals in 3 stages. Ultimately, 16 clinical trials, cohort studies, case reports, and case series articles were obtained after reading the title, abstract, and full text and considering the exclusion criteria. The data of the final article were entered into the analysis table. This study was registered with PROSPERO (registration number CRD42022334409) and conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Results: Amantadine seems to be associated with a higher overall response rate. In contrast, modafinil is associated with the most remarkable change in GCS score during treatment. However, the number of clinical trials with high quality and sample size has not been satisfactory to compare the effectiveness of these 2 drugs and their potential side effects.Conclusions: The authors recommend additional double-blind clinical trials are needed to be conducted with a larger sample size, comparing amantadine with modafinil to delineate the efficacy and adverse effects, both short and long term.","PeriodicalId":10449,"journal":{"name":"Clinical Neuropharmacology","volume":"46 6","pages":"229-238"},"PeriodicalIF":0.8000,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Neuropharmacology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/WNF.0000000000000577","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/10/19 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Objectives: Acute traumatic brain injury is one of the most common causes of death and disability. Reduction in the level of consciousness is a significant complication that can impact morbidity. Glasgow Coma Scale (GCS) is the most widely used method of assessing the level of consciousness. Neurostimulants such as amantadine and modafinil are common pharmacologic agents that increase GCS in patients with brain trauma. This study aimed to compare the effectiveness of these 2 drugs.

Methods: This systematic review obtained articles from Google Scholar, PubMed, Scopus, Embase, and MEDLINE databases. Extensive searches were conducted separately by 4 individuals in 3 stages. Ultimately, 16 clinical trials, cohort studies, case reports, and case series articles were obtained after reading the title, abstract, and full text and considering the exclusion criteria. The data of the final article were entered into the analysis table. This study was registered with PROSPERO (registration number CRD42022334409) and conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Results: Amantadine seems to be associated with a higher overall response rate. In contrast, modafinil is associated with the most remarkable change in GCS score during treatment. However, the number of clinical trials with high quality and sample size has not been satisfactory to compare the effectiveness of these 2 drugs and their potential side effects.

Conclusions: The authors recommend additional double-blind clinical trials are needed to be conducted with a larger sample size, comparing amantadine with modafinil to delineate the efficacy and adverse effects, both short and long term.

查看原文本刊更多论文

外伤性脑损伤的意识恢复:莫达非尼与金刚烷胺比较的系统综述。

目的:急性创伤性脑损伤是导致死亡和残疾的最常见原因之一。意识水平降低是影响发病率的重要并发症。格拉斯哥昏迷量表(GCS)是最广泛使用的评估意识水平的方法。金刚烷胺和莫达非尼等神经兴奋剂是增加脑外伤患者GCS的常见药物。本研究旨在比较这两种药物的疗效。方法:本系统综述从谷歌Scholar、PubMed、Scopus、Embase和MEDLINE数据库中获取文章。4个人分3个阶段分别进行了广泛的搜索。在阅读标题、摘要和全文并考虑排除标准后，最终获得了16篇临床试验、队列研究、病例报告和病例系列文章。最后一篇文章的数据输入到分析表中。本研究已在PROSPERO注册(注册号CRD42022334409)，并按照系统评价和荟萃分析指南的首选报告项目进行。结果:金刚烷胺似乎与更高的总有效率有关。相比之下，莫达非尼与治疗期间GCS评分的变化最为显著。然而，高质量和样本量的临床试验数量尚不能令人满意地比较这两种药物的有效性及其潜在副作用。结论:作者建议需要进行更多的双盲临床试验，样本量更大，比较金刚烷胺和莫达非尼，以描述短期和长期的疗效和不良反应。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Clinical Neuropharmacology 医学-临床神经学

CiteScore

1.20

自引率

10.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Clinical Neuropharmacology is a peer-reviewed journal devoted to the pharmacology of the nervous system in its broadest sense. Coverage ranges from such basic aspects as mechanisms of action, structure-activity relationships, and drug metabolism and pharmacokinetics, to practical clinical problems such as drug interactions, drug toxicity, and therapy for specific syndromes and symptoms. The journal publishes original articles and brief reports, invited and submitted reviews, and letters to the editor. A regular feature is the Patient Management Series: in-depth case presentations with clinical questions and answers.