ABSTRACT
BACKGROUND: A previous study suggested that the routine use of drugs intended to improve attention and arousal, such as methylphenidate, tend to have a variable but not significant effect on sleep-wake cycles. As amantadine is a frequently employed drug in brain injury rehabilitation, with known effects on fatigue and motor processing speed, this study examined the effect of amantadine on the sleep-wake behaviour of patients with brain injury undergoing rehabilitation. METHOD: This was a naturalistic observation using an observationally defined sleep-wake distribution for a total of 43 subjects with brain injury. Identified patients were observed for a full 24 hours a day 2 weeks before and 2 weeks after starting amantadine. Some of these patients (n = 12) had been administered amantadine on clinical grounds and, for this paper, served as the experimental group, while the drug naive (n = 31) served as a control. Three outcome measures were operationalized: hours of sleep in 24 hours, hours of sleep during daytime and hours of sleep during night-time. RESULT: The average number of hours of sleep during a 24-hour period was not significantly different for the two cohorts. Similarly hours of sleep during daytime and hours of sleep during night-time were on average the same for the two groups. The data suggest that amantadine has no direct bearing on sleep/wake cycles using these parameters. CONCLUSION: This study fails to demonstrate that the use of amantadine on an inpatient brain injury population will affect sleep/wake quantity.
Subject(s)
Amantadine/pharmacology , Brain Injuries/drug therapy , Dopamine Agents/pharmacology , Sleep Disorders, Circadian Rhythm/drug therapy , Adolescent , Adult , Aged , Aged, 80 and over , Amantadine/administration & dosage , Amantadine/adverse effects , Brain Injuries/physiopathology , Dopamine Agents/administration & dosage , Dopamine Agents/adverse effects , Drug Administration Schedule , Female , Humans , Male , Middle Aged , Polysomnography , Retrospective Studies , Time Factors , Young AdultABSTRACT
OBJECTIVE: The purpose of this study was to evaluate the effects of methylphenidate on heart rate and blood pressure in patients with acquired brain injury. DESIGN: The records of 60 consecutive hospitalized patients with acquired brain injury were reviewed for treatment with methylphenidate. Seventeen patients met the inclusion criteria. Systolic blood pressure, diastolic blood pressure, and heart rate recordings were compared before and after the introduction of methylphenidate. RESULTS: There was no significant difference in mean systolic blood pressure, diastolic blood pressure, and heart rate when patients received (118 mm Hg, 74 mm Hg, and 88 bpm) and did not receive (118 mm Hg, 73 mm Hg, and 86 bpm) methylphenidate. It was unclear whether there was a true trend toward medication effect on heart rate and blood pressure during the peak dose period. CONCLUSIONS: This retrospective study points to safe sympathetic effects of methylphenidate, yet future prospective studies are warranted to clarify the effects of methylphenidate on heart rate and blood pressure in the acquired brain injury population.