(Brand names in India: Amantrel, Parkitidin)

How does Amantadine act?

Amantadine is a another friend of levodopa (remember: its other friend is entacapone).

While it can decrease the symptoms of Parkinson’s disease, it works best when it is given to support the action of levodopa.

While Entacapone can sometimes increase the side-effects of levodopa, Amantadine is the friend who smoothens out your rough edges, makes you a better person. Amantadine decreases some side-effects of levodopa and makes it more wonderful.

Levodopa’s two friends: Entacapone & Amantadine.

No one quite understands how Amantadine works for Parkinson’s disease. It was originally designed to kill the influenza virus. However, doctors accidentally discovered that it makes Parkinson’s disease better as well.

It has one, fantastic and unique effect in Parkinson’s disease that is described below.

Use/Advantages:

    1. Treatment of “Dyskinesias”: Some patients with Parkinson’s disease start getting bothersome movements of the hands, legs and neck after a few years of treatment. I want you to understand these movements. So with all respect: please allow me to describe these movements in the simplest way possible. These movements are dance-like movements, somewhat similar to the way Michael Jackson dances on stage. The Latin word for dance is chorea, and therefore these movements are called chorei-form (dance-like) movements. Since that word is very complicated, they are also called “Dyskinesias”. These movements are often time-linked to levodopa. They are maximum in intensity 30 min – 1 hour after taking levodopa.

      Dyskinesias are dance-like movements.

      Amantadine has one fantastic effect – it decreases these movements tremendously. For patients who have not been able to take enough levodopa because of these movements, it enables intake of an adequate quantity of levodopa, so that they can have a much better quality of life.

    2. It may smoothen-out the effect of levodopa, and can help in relieving “Predictable wearing OFF” to some degree. But, other stratergies such as entacapone, long-acting medications etc are much more useful for this purpose.
    3. Rarely, it can be given as the only medication for Parkinson’s disease. But when used by itself, its effectiveness is limited.

Disadvantages:

  1. Most people don’t have any side-effects from Amantadine. Some people can have mild swelling or slight purplish discolouration of the feet.
  2. Since it is an anti-viral, it can decrease the effectiveness of some viral vaccines. If a live viral vaccine (e.g. Hepatitis B vaccine) needs to be given, Amantaide should be stopped 2 weeks prior and 2 days after the vaccine is administered.

    Amantadine can decrease the effectiveness of some vaccines.

Bottom-line:

It is used to control troublesome dance-like movements caused by high doses of levodopa. Although it is only modestly effective by itself, it is extremely good at smoothing out the rough edges of our superstar (levodopa), hence the sorbiquet – The lawyer of levodopa.

 


Dr. Siddharth Kharkar

Dr. Kharkar is a Neurologist, Epilepsy specialist & Parkinson’s disease specialist in Mumbai, Maharashtra, India. He has trained in the best institutions in India, US and UK including KEM hospital in Mumbai, Johns Hopkins University in Baltimore, University of California at San Francisco (UCSF), USA & Kings College in London.

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