Comparative Study between the Efficacy of Amantadine Sulphate versus Erythropoietin on Traumatic Brain Injury

Abstract
Background: Traumatic Brain Injury (TBI) is the most common cause of death and disability. Improvement of recov-ery is a challenging process in cases with varying degrees of severe brain injury requiring intensive care. Fortunately, a number of pharmacological interventions show promise in helping patients cope with these losses and deficits. Medica-tions may be used to support recovery, Examples are Eryth-ropoietin (EPO) and Antiparkinsonian drugs (Amantadine Sulphate).
Aim: To compare the efficacy of Amantadine Sulphate versus Erythropoietin on improvement of traumatic brain injury outcome.
Material and Methods: This study was carried out on three equal groups each group consist of 20 patients according to sample size calculation based on the fact, whether they received or didn't receive Amantadine Sulphate or Erythro-poietin in addition to standard therapy.
Group I (Amantadine Group): Patients were received Amantadine Sulphate in dose of 200mg twice daily intravenous (IV) at 9:00am and 3:00pm for 1 week, from 3rd day of hospitalization then oral Amantadine Sulphate 200mg twice daily for 3 weeks in addition to standard therapy.
Group II (Erythropoietin Group): Patients received Eryth-ropoietin subcutaneously (SC) from 3rd day of injury 40,000 International Units (IU) once per week for maximum 3 doses at day 3, 10 and 17 including standard therapy.
Group III (Control Group): Patients received placebo (0.9% saline) for 4 weeks (standard therapy only). The fol-lowing measurements were recorded: Glasgow Coma Scale (GSC), Disability Rating Scale (DRS), Sedation scale, length of mechanical ventilation, length of surgical ICU stay, hospital stay and complications.
Results: In the group of patients with severe brain injuries treated with standard therapy plus Amantadine Sulphate, consciousness was better, the case fatality rate was lower and length of mechanical ventilation, SICU stay and hospital stay were shorter than in the group treated with standard therapy plus Erythropoietin and the group treated with standard therapy only.
Conclusions: Using of Amantadine Sulphate is better than using of Erythropoietin for improving neurorecovery on Traumatic Brain Injury (TBI), also we concluded that Eryth-ropoietin is a potentially useful treatment option for TBI but confirmatory evidence is required for that and for the ability of EPO to increase the risk of Venous Thromboembolism (VTE).