Amantadine : Developed as an antiviral drug for prophylaxis of influenza A2, it was found serendipitiously to benefit parkinsonism. It acts rapidly but has lower efficacy than levodopa, though higher than anticholinergics. About 2/3rd patients derive some benefit.
DOPAMINE FACILITATOR
Amantadine
Developed as an
antiviral drug for prophylaxis of
influenza A2, it was found serendipitiously to benefit parkinsonism.
It acts rapidly but has lower efficacy than levodopa, though higher than
anticholinergics. About 2/3rd patients derive some benefit. However, tolerance
develops over months and the efficacy is lost. Amantadine appears to act by
promoting presynaptic synthesis and release of DA in brain. Action on NMDA type
of glutamate receptors, through which the striatal dopaminergic system exerts
its influence is now considered to be more important.
Amantadine can be used in milder cases, or in short courses to
supplement levodopa for advanced cases. In the latter situation, it serves to
suppress motor fluctuations and abnormal movements. Fixed dose of 100 mg BD is
used (not titrated according to response). Effect of a single dose lasts 8–12
hours;
AMANTREL, COMANTREL
100 mg tab.
Side Effects
These are generally not serious: insomnia, dizziness,
confusion, nightmares, anticholinergic effects and rarely hallucinations. A
characteristic side effect due to local release of CAs resulting in
vasoconstriction is livedo reticularis and edema of ankles.
Side effects are accentuated when it is combined with
anticholinergics.
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