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Pathophysiology
Published in Ibrahim Natalwala, Ammar Natalwala, E Glucksman, MCQs in Neurology and Neurosurgery for Medical Students, 2022
Ibrahim Natalwala, Ammar Natalwala, E Glucksman
The history and findings are typical of Parkinson’s disease.9 Amantadine is a drug that can be used in the treatment of both Parkinson’s and influenza A. It blocks viral penetration as well as uncoating of the influenza virus and releases dopamine from intact nerve terminals. Since Parkinson’s disease is highly associated with decreased dopamine levels, amantadine is useful in these patients. Side effects of amantadine include ataxia, dizziness and slurred speech.10 It should be remembered that amantadine is not a first-line drug in the treatment of Parkinson’s disease.
Anti-Infective Agents
Published in Radhwan Nidal Al-Zidan, Drugs in Pregnancy, 2020
Risk Summary: It is better to be avoided during the 1st Trimester because the pregnancy experience in humans is limited, and the reproduction studies in animals have shown the risk of teratogenicity associated with the use of Amantadine. It is believed that Rimantadine has a lower risk of harmful effects than Amantadine
Drug therapy
Published in Jeremy Playfer, John Hindle, Andrew Lees, Parkinson's Disease in the Older Patient, 2018
Amantadine is an unusual drug. Its anti-parkinsonian effect was discovered by chance when it was being used as an anti-viral agent.46 Pharmacologically amantadine resembles anticholinergic drugs. It also appears to have effects modulating dopamine re-uptake and the releasing of dopamine stores. More recently amantadine has been shown to have anti-NMDA receptor activity, blocking the action of glutamate within the basal ganglia circuitry.47 There are reports that it may be beneficial in reducing levodopa-induced dyskinesias.48 The recommended dose for amantadine is 100 mg daily, increased after one week to 100 mg twice daily to a maximum of 400 mg. The drug must be used in caution with the elderly and a daily dose over 200 mg has a significant risk of psychiatric side effects. Amantadine is best used as adjunct therapy. It can give a short-term boost to anti-Parkinson treatments on special occasions for the patient. There are many cautions and potential interactions with this drug. In particular, it should be avoided in patients with hepatic or renal impairment. It may cause significant fluid retention. Gastro-intestinal disturbances, insomnia and anxiety, vasculitis (livedo reticularis) and visual disturbance are side effects which frequently curtail the use of amantadine. In longer-term use it is difficult to withdraw and side effects such as weight loss, cognitive impairment and hallucinations become more evident.
Efficacy and safety of amantadine as a treatment for apathy after brain injury: Two single-case experimental design studies
Published in Neuropsychological Rehabilitation, 2022
Peggy Spauwen, Bert Ter Mors, Peter van Harten, Anne-Fleur Domensino, Rudolf Ponds, Caroline van Heugten
Amantadine hydrochloride and a visually identical placebo (microcrystalline cellulose) were administered during the intervention phase. Amantadine is absorbed slowly but almost completely. Peak plasma concentrations of approximately 250 and 500 ng/ml are seen three to four hours after single oral administration of 100 and 200 mg amantadine, respectively. In order to gradually introduce and withdraw amantadine, 100 mg amantadine was administered in the first and last week of the amantadine phase and 200 mg in the second to fourth week. Three weeks of 200 mg was considered enough time because following repeated administration of 200 mg amantadine daily the steady-state plasma concentration settles at 300 ng/ml within 3 days (Aoki et al., 1985; Aoki & Sitar, 1988; Gualtieri et al., 1989). Regarding the wash-out period, amantadine is eliminated in healthy young adults with a mean plasma elimination half-life of 15 h (www.accessdata.fda.gov). Participants were provided with a container for every week. To ensure optimal efficacy of amantadine, medication compliance must be >80% (Tate et al., 2013). In this study, treatment adherence was checked by the principal investigator by asking the participant and caregiver about the pill intake.
Amantadine for the treatment of childhood and adolescent psychiatric symptoms
Published in Baylor University Medical Center Proceedings, 2021
Kyle Morrow, Sun Choi, Keith Young, Makram Haidar, Cassandra Boduch, James A. Bourgeois
Amantadine hydrochloride, an indirect dopamine agonist and N-methyl-D-aspartate receptor antagonist, can modulate symptoms of childhood psychiatric disorders.1–4 Multiple studies have reported effective off-label use of amantadine in attention deficit/hyperactivity disorder (ADHD) and as an augmenting agent in treatment-resistant unipolar depression, autism spectrum disorder, and obsessive-compulsive disorder.5–13 Common side effects of amantadine include nausea, dizziness, and insomnia.14 Rare side effects include psychosis, hypertension, livedo reticularis, and rash.15 Stimulants and nonstimulants used to treat ADHD are associated with more severe side effects, while antipsychotics have been associated with weight gain, extrapyramidal symptoms, QTc prolongation, and sedation.16,17 Some studies report that amantadine can reverse weight gain induced by antipsychotics.18–23 This study was a retrospective chart review of children and adolescents prescribed amantadine to assess its tolerability and treatment outcomes for psychiatric symptoms.
Evaluating ADS5102 (amantadine) for the treatment of Parkinson’s disease patients with dyskinesia
Published in Expert Opinion on Pharmacotherapy, 2019
Thomas Müller, Wilfried Kuhn, Jan-Dominique Möhr
A low incidence of side effects is one of the major benefits of amantadine. Livedo reticularis and pedal edema are common. Livedo reticularis is usually limited to the skin of the legs. Distinct less common, but more troublesome, are the mental side effects such as confusion, visual hallucinations and insomnia. They promptly disappear with drug discontinuation. Generally, the cognitive side effects were reported in individuals with an underlying pre-existing cognitive dysfunction. There is even one case report on a dropped head syndrome occurring with amantadine exposure, which again disappeared after stopping the amantadine treatment [34]. The predominant renal amantadine excretion asks for cautious use of amantadine in patients with impaired kidney function. Dry mouth and blurred visions are probably related to the mild anticholinergic properties of amantadine.