Citation

Hosenbocus S, Chahal R. J. Can. Acad. Child Adolesc. Psychiatry 2013; 22(1): 55-60.

Copyright

(Copyright © 2013, Canadian Academy of Child and Adolescent Psychiatry)

DOI

unavailable

PMID

unavailable

Abstract

OBJECTIVE: To review published literature regarding the pharmacology and use of amantadine in child and adolescent psychiatry.

METHOD: A literature search of several databases (PubMed, Psychinfo, CINAHL, Medline, PsycARTICLES, Biomedical Reference Collection and Academis Search Complete) was conducted with the search terms: 'amantadine' with limits: English language, Human trials, all child (aged 0-18 years). The search was later expanded to include 'Adults' and additional relevant articles were selected from reference lists.

RESULTS: The psychotropic effect of amantadine is related to its antagonism of the N-methyl-D-aspartate (NMDA) receptor. It decreases the toxic effects of the glutamatergic neurotransmitter system which plays an important role in many psychiatric disorders. Two randomized controlled trials (RCTs) of amantadine were identified in children and adolescents. One reported beneficial effects in controlling the symptoms of irritability and hyperactivity in autistic disorder and the other described a significant impact in attention deficit hyperactivity disorder (ADHD). Two open label studies also reported positive effects in ADHD. A pilot study in children with enuresis reported significant reduction in wetting frequency. Studies in adults, with relevance to children and adolescents, reported effectiveness in resistant depression, obsessive compulsive disorder and in counteracting side effects of some psychotropic medications. RCTs found in traumatic brain injury indicated a neuroprotective effect and effectiveness in controlling agitation and aggression. Amantadine is well tolerated in children and adolescents, with an acceptable side effect profile, and considered safe for long term use.

CONCLUSION: Amantadine shows potential for use as a safe alternative or as an augmenting agent for treating children with neuropsychiatric and various other disorders. Available data for such use, although promising, require further confirmation.

Language: en

Keywords

adolescent; human; child; autism; insomnia; suicidal ideation; depression; psychosis; patient safety; suicide attempt; article; anorexia; child psychiatry; xerostomia; patient monitoring; hallucination; somnolence; paranoia; urine retention; constipation; drug mechanism; orthostatic hypotension; delusion; neuropathology; confusion; drug safety; placebo; drug blood level; drug efficacy; risperidone; drug tolerability; nausea; drug withdrawal; irritability; drug effect; hypertension; side effect; attention deficit disorder; agitation; methylphenidate; drug absorption; drug half life; dose response; creatinine blood level; low drug dose; obsessive compulsive disorder; thought disorder; Pharmacology; amantadine; enuresis; dizziness; drug eruption; slurred speech; aripiprazole; urea nitrogen blood level; drug dose reduction; n methyl dextro aspartic acid receptor; drug induced headache; drug dose increase; clinical effectiveness; neuroprotection; drug excretion; decreased appetite; receptor blocking; fetal alcohol syndrome; morning dosage; randomized controlled trial (topic); recommended drug dose; livedo reticularis; Amantadine; Glutamatergic system; N-methyl-D-aspartate receptor