A Thomas, D Iacono, AL Luciano, K Armellino, A Di Iorio, M Onofrj
J Neurol Neurosurg Psychiatry 2004;75:141-143
Amantadine’s ability to reduce dyskinesias lasts less than 8 months, according to this study.
Forty PD patients with levodopa-induced dyskinesia were randomized to receive placebo or up to 300 mg amantadine daily. Dyskinesia was assessed by blinded investigators with UPDRS IV questions 32-34, Dyskinesia Rating Scale and an Investigator Global Assessment. UPDRS I-III was also administered.
The primary endpoint was the time to dropout due to dyskinesias worse than baseline.
Three patients in the amantadine group withdrew due to side effects, including tachycardia, livedo reticularis and psychosis. All placebo patients had discontinued by 3 months due to worsening dyskinesias. In the amantadine group, dyskinesias were significantly better than baseline at 15 days and 30 days. Over the next 7 months, average dyskinesias scores returned to baseline for all patients, such that no patients remained in treatment after 8 months. UPDRS I-III scores did not change significantly from baseline to end of treatment. Following withdrawal of amantadine, two patients experienced hyperthermia, which subsided with reintroduction and more gradual withdrawal. Eleven patients experienced an abrupt increase of dyskinesia to 100% of daily time awake. Reduction of levodopa dose and increased dosing reduced dyskinesias. No difference between placebo and amantadine groups was seen one month after treatment cessation.
The authors conclude that, based on their results, “the administration Of amantadine cannot be viewed as a long-lasting solution to the occurrence of dyskinesia and fluctuations in patients with severe Parkinson’s disease.”
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