Amantadine Expert Views

Dr. Raj Pahwa discusses the use of Amantadine, an older medication, for managing dyskinesias in Parkinson's patients. Dyskinesias are involuntary movements that can occur as a side effect of Parkinson's treatments. Amantadine works by targeting neurotransmitters like glutamate, which may play a role in dyskinesias. Extended-release versions of Amantadine, such as ADS-5102, are taken at bedtime and provide peak levels in the morning, helping to reduce dyskinesias and 'off' times throughout the day. Phase 3 studies showed significant improvements in both dyskinesias and 'off' times, making it the first medication approved in the U.S. for levodopa-induced dyskinesias.

Amantadine, originally a flu medication, is being studied for its potential to treat dyskinesia, which are uncontrolled movements often linked to long-term use of Parkinson's medications like Carbidopa-Levodopa. Experts emphasize the importance of thorough testing to ensure safety and effectiveness, as off-label use of drugs can lead to side effects and interactions with other medications. The scientific community is encouraged to collaborate with patients and researchers to clearly define treatment goals.

Amantadine, originally approved as an antiviral for influenza, has been found to help with Parkinson's disease symptoms and reduce dyskinesia, a side effect of levodopa treatment. Dyskinesia refers to involuntary movements that can occur in Parkinson's patients. Amantadine works not by directly affecting dopamine, the brain chemical often targeted in Parkinson's treatments, but by acting on other brain systems that modify dopamine's effects. This unique mechanism makes it useful for managing dyskinesia.

Dr. Aaron Haug explains that Amantadine is a long-standing medication used to treat motor symptoms in Parkinson's disease. It is unique because it can reduce dyskinesias (involuntary movements) when the dosage is increased, unlike other medications. However, it has side effects like dry eyes, dry mouth, constipation, and hallucinations, which become more common as patients age. Dr. Haug finds it most helpful for patients in their 50s and early 60s, but uses it less frequently for older individuals due to these side effects.

Dr. Oksana Suchowersky explains that Amantadine is an older drug used in Parkinson's treatment, working similarly to anticholinergics by balancing chemicals in the brain. It is relatively inexpensive and available in generic forms, making it accessible for patients. However, she emphasizes that the choice of medication depends on factors like age, severity of symptoms, and cost considerations. For younger patients with prominent tremors, anticholinergics might be considered, but they are generally avoided in older patients due to memory-related side effects.

Jennifer Goldman discusses the management of Parkinson's disease, particularly focusing on the balance between mental and motor functions. She highlights the importance of reducing or discontinuing certain Parkinson's medications, including Amantadine, to manage symptoms like hallucinations. Goldman also emphasizes the role of non-pharmacologic strategies, such as reassurance and artistic depictions, alongside medications for psychosis. She reviews evidence-based approaches to psychosis treatment in Parkinson's, noting the efficacy and safety of various drugs, while cautioning against dopamine-blocking medications that can worsen motor symptoms.

Amantadine, a medication used primarily to treat dyskinesia in Parkinson's patients, has been associated with a slight increase in the risk of developing impulse control disorders (ICDs). These disorders include compulsive behaviors such as gambling, buying, sex, or eating. Research indicates that untreated Parkinson's patients have similar rates of ICDs as healthy individuals, but the introduction of medications, including amantadine, can elevate this risk. While dopamine agonists pose the highest risk for ICDs, amantadine and other Parkinson's medications also contribute to this issue, particularly at higher dosages.

Amantadine is discussed as a treatment option for dyskinesia, a common side effect of Parkinson's medications like levodopa. Experts note that while amantadine can provide some benefits, its effectiveness is considered mild. It may help prevent dyskinesia and improve Parkinson's symptoms, but it is not a perfect solution. The webinar also highlights the social and physical challenges dyskinesia causes, such as fatigue and isolation, emphasizing the need for better management strategies.

Dr. Ramon Rodriguez explains that Amantadine, particularly in its extended-release form (like Gocovri), is used to treat dyskinesias, which are involuntary movements often seen in Parkinson's patients. While some patients may experience mild dyskinesias that don't bother them, others suffer from severe cases, making them ideal candidates for this medication. He notes potential side effects, including dizziness, hallucinations, paranoia, nausea, rash, leg discoloration, and dry mouth. Despite these risks, Dr. Rodriguez emphasizes the importance of understanding the side effects rather than avoiding the medication altogether.

Amantadine, a medication used primarily to treat dyskinesia in Parkinson's disease, has been associated with a slight increase in the risk of impulse control disorders. This risk is not as high as with dopamine agonists, but it appears to increase at higher doses. The onset of these problems may take several years, with an average time of 4 to 5 years after starting treatment. Deep brain stimulation is sometimes used to reduce Parkinson's medications, including dopamine agonists, which can help improve impulse control disorders. However, there are cases where impulse control disorders develop after deep brain stimulation, possibly due to post-operative medication adjustments.