The following is a summary of “Amantadine in unvaccinated patients with early, mild to moderate COVID-19: a randomized, placebo-controlled, double-blind trial,” published in the August 2023 issue of Neurology by Rejdak et al.

Adamantanes emerged as a compelling early intervention for COVID-19. Researchers performed a cohort study to assess how effective amantadine (AMD) is in halting the advancement of COVID-19 and its associated neurological outcomes.

They enrolled unvaccinated patients with SARS-CoV-2 infection within 5 days. Subjects were randomly split (50:50) to take either AMD 100 mg or a placebo (PLB 14 days). Primary assessment, WHO ordinary scale; secondary was fatigue, depression, smell/taste disorders, and sleepiness (Days 1 &15).

The results showed 99 patients (49 AMD and 50 PLB). In AMD, 3 (6%) showed disease progression (WHO=4) compared to 4 (8%) in PLB (P>0.05). Complete recovery on day 15 was 60% > in the AMD group than the PLB group (P= 0.025). Both AMD and PLB groups showed improvement in taste (AMD: P= 0.003; PLB: P= 0.0001) and smell (AMD: P= 0.005; PLB: P= 0.0004), AMD group exhibited gain in fatigue (P= 0.010), not the PLB group (P= 0.058). For depression and sleepiness, improvement was seen in the AMD group (P= 0.0002; P= 0.341 for PLB). Until Day 210, 1 death in the PLB group (2.0%), with none in the AMD (P>0.05); the drug was well relevant.

They concluded that reduced sleepiness and depression may have aided faster recovery in early COVID-19 patients.

Source: onlinelibrary.wiley.com/doi/abs/10.1111/ene.16045