The Effect of Amantadine on Levodopa-induced Dyskinesias in Parkinson's Disease: A Double-blind, Placebo-controlled Study

Abstract

We performed a double-blind, placebo-controlled, crossover study to assess the effect of amantadine versus placebo on levodopa-induced dyskinesias in Parkinson's disease. We found a 24% reduction in the total dyskinesia score after amantadine administration (p = 0.004). This improvement was achieved without any influence on the severity of "on" period parkinsonism. The results confirm that amantadine reduces levodopa dyskinesias and support the hypothesis that dyskinesias can be reduced by blockade of excitatory pathways in the basal ganglia.

Practice Parameter: Treatment of Parkinson disease with motor fluctuations and dyskinesia (an evidence-based review): [RETIRED]

“…Two studies, one Class II and one Class III, evaluated the efficacy of medications in reducing dyskinesia. 34,35 A Class II single center, double masked, placebo controlled, randomized, crossover trial enrolled 24 subjects for 3 weeks of treatment with amantadine (100 mg BID) and placebo. 34 Ninety-two percent of the subjects completed the trial.…”

Dyskinesia and the antiparkinsonian response always temporally coincide

“…Amantadine suppresses dyskinesia without worsening parkinsonism, as shown in several small clinical trials. 20,21 But even here there is a hint that amantadine may blunt the antiparkinsonian response in primates, 22 as is true with another proposed antidyskinetic drug, sarizotan. 23 It is important to point out some caveats about this study.…”

Animal models of Parkinson's disease and their applications

“…111 Effects on l-DOPA-induced dyskinesia One double-blind, placebo-controlled study showed that amantadine reduced l-DOPA-induced dyskinesia in PD. 112 Pilot studies also suggest that cannabinoids and aripiprazole can reduce l-DOPA-induced dyskinesia in PD. 113,114 Endocannabinoids reduce l-DOPA-induced dyskinesia in an MPTP-induced cynomolgus monkey model of PD.…”