טיפול תרופתי באמנטדין : תצפית על היעילות הקלינית בקרב ילדים המטופלים בבית חולים שיקומי

Objectives: To assess the effectiveness, feasibility, and compliance of Amantadine treatment in pediatric patients who present with one of the following clinical symptoms: refractory seizures, movement disorder, attention disorder, behavioral regulation disorder or altered conscious state, within the setting of a pediatric rehabilitation hospital.

Methods: A retrospective study, including 61 patients - 36 males (59%) and 25 females (41%), 1.7 to 17.9 years old, who were prescribed with Amantadine. Retrospective data (Demographic, clinical, and radiologic) was retrieved from the patient`s medical records, in addition – a designated questionnaire was filled by the patient`s parents regarding their subjective and retrospective evaluation of treatment effectiveness. Descriptive statistics and fisher exact test were used for analysis, p-value ≤ 0.05 was considered significant.

Results: Treatment compliance was observed in 87% (53) of the patients. Mild to moderate adverse side effects (ASE) were reported by 55% (29) of the patients. 61% (32) of the patients manifested improvement in at least one target symptom. The degree of improvement reported for different symptoms: altered consciousness states - 71%, seizures - 60%, movement and behavioral disorders - 50%, balance disorders - 38% and attention disorders - 37%. A significant association (p=0.02) was found between renewal or continued use of amantadine treatment and improvement in target symptoms: among the 13 patients who renewed or continued amantadine treatment, improvement was observed in 92% (12).

Conclusion: These results provide important evidence demonstrating that amantadine may be effective in the treatment of a range of pediatric neurological disorders, especially in cases of refractory convulsions and behavioral disorders. Amantadine’s adverse side effects are relatively mild. Further investigation is needed to confirm the effectiveness and safety of amantadine and define new biomarkers for treatment specification and precision to determine which patients are the best candidates for this drug therapy.