Amantadine as treatment for dyskinesias and motor fluctuations in Parkinson's disease
LV Metman, P Del Dotto, P Van Den Munckhof, J Fang… - Neurology, 1998 - AAN Enterprises
LV Metman, P Del Dotto, P Van Den Munckhof, J Fang, MM Mouradian, TN Chase
Neurology, 1998•AAN EnterprisesObjective: To determine the effects of the N-methyl-D-aspartate (NMDA) antagonist
amantadine on levodopa-associated dyskinesias and motor fluctuations in Parkinson's
disease (PD). Background: NMDA receptor blockade can ameliorate levodopa-induced
dyskinesias in primates and PD patients. Amantadine, a well-tolerated and modestly
effective antiparkinsonian agent, was recently found to possess NMDA antagonistic
properties. Methods: Eighteen patients with advanced PD participated in a double-blind …
amantadine on levodopa-associated dyskinesias and motor fluctuations in Parkinson's
disease (PD). Background: NMDA receptor blockade can ameliorate levodopa-induced
dyskinesias in primates and PD patients. Amantadine, a well-tolerated and modestly
effective antiparkinsonian agent, was recently found to possess NMDA antagonistic
properties. Methods: Eighteen patients with advanced PD participated in a double-blind …
Objective: To determine the effects of the N-methyl-D-aspartate (NMDA) antagonist amantadine on levodopa-associated dyskinesias and motor fluctuations in Parkinson's disease (PD).
Background: NMDA receptor blockade can ameliorate levodopa-induced dyskinesias in primates and PD patients. Amantadine, a well-tolerated and modestly effective antiparkinsonian agent, was recently found to possess NMDA antagonistic properties.
Methods: Eighteen patients with advanced PD participated in a double-blind, placebo-controlled, cross-over study. At the end of each 3-week treatment arm, parkinsonian and dyskinesia scores were obtained during a steady-state intravenous levodopa infusion. Motor fluctuations and dyskinesias were also documented with patient-kept diaries and Unified Parkinson's Disease Rating Scale (UPDRS) interviews.
Results: In the 14 patients completing this trial, amantadine reduced dyskinesia severity by 60% (p = 0.001) compared to placebo, without altering the antiparkinsonian effect of levodopa. Motor fluctuations occurring with patients' regular oral levodopa regimen also improved according to UPDRS and patient-kept diaries.
Conclusions: These findings suggest that amantadine given as adjuvant to levodopa can markedly improve motor response complications and support the view that hyperfunction of NMDA receptors contributes to the pathogenesis of levodopa-associated motor complications.
American Academy of Neurology