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Amantadine as treatment for dyskinesias and motor fluctuations in Parkinson's disease.
Neurology. 1998 May; 50(5):1323-6.Neur

Abstract

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.

Authors+Show Affiliations

Verhagen Metman L
Experimental Therapeutics Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892-1406, USA.
Del Dotto P
No affiliation info available
van den Munckhof P
No affiliation info available
Fang J
No affiliation info available
Mouradian MM
No affiliation info available
Chase TN
No affiliation info available

MeSH

AdultAgedAmantadineAntiparkinson AgentsCross-Over StudiesDouble-Blind MethodDyskinesia, Drug-InducedExcitatory Amino Acid AntagonistsFemaleHumansLevodopaLogistic ModelsMaleMiddle AgedMotor ActivityParkinson DiseaseReceptors, N-Methyl-D-AspartateTreatment Outcome

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

9595981

Clinical Trial Links

Open-Label Safety Study of ADS-5102 in PD Patients With LID
Quantification of the Antidyskinetic Effect of Amantadine and Topiramate in Parkinson's Disease

Citation

Verhagen Metman, L, et al. "Amantadine as Treatment for Dyskinesias and Motor Fluctuations in Parkinson's Disease." Neurology, vol. 50, no. 5, 1998, pp. 1323-6.
Verhagen Metman L, Del Dotto P, van den Munckhof P, et al. Amantadine as treatment for dyskinesias and motor fluctuations in Parkinson's disease. Neurology. 1998;50(5):1323-6.
Verhagen Metman, L., Del Dotto, P., van den Munckhof, P., Fang, J., Mouradian, M. M., & Chase, T. N. (1998). Amantadine as treatment for dyskinesias and motor fluctuations in Parkinson's disease. Neurology, 50(5), 1323-6.
Verhagen Metman L, et al. Amantadine as Treatment for Dyskinesias and Motor Fluctuations in Parkinson's Disease. Neurology. 1998;50(5):1323-6. PubMed PMID: 9595981.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Amantadine as treatment for dyskinesias and motor fluctuations in Parkinson's disease. AU - Verhagen Metman,L, AU - Del Dotto,P, AU - van den Munckhof,P, AU - Fang,J, AU - Mouradian,M M, AU - Chase,T N, PY - 1998/5/22/pubmed PY - 1998/5/22/medline PY - 1998/5/22/entrez SP - 1323 EP - 6 JF - Neurology JO - Neurology VL - 50 IS - 5 N2 - 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. SN - 0028-3878 UR - https://www.unboundmedicine.com/medline/citation/9595981/Amantadine_as_treatment_for_dyskinesias_and_motor_fluctuations_in_Parkinson's_disease_ DB - PRIME DP - Unbound Medicine ER -