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Hilary have you tried memantine (Namenda), an Alzheimer's drug found to help some dyskinesia? Or try to find out more about Tetrabenazine, a drug from Europe, Australia or Canada. Namenda for dyskinesia use is in Phase III trials in the US. A contact would be Joseph Jankovic, MD, Professor of Neurology, Director, Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, Texas Also, the jury is still out on riluzole, but worth checking into. Peggy Willocks (See current articles below). ##### Memantine can relieve certain symptoms in Parkinson disease. Improvement achieved in two out of three described cases with dyskinesia and cognitive failure (2004) Lokk J. Parkinson's disease is a chronic, progressive, neurodegenerative disease with a reduction of dopamine levels causing the typical symptoms tremor, hypokinesia, rigidity, and postural disturbance. After some years with Parkinson's disease patients tend to develop fluctuating symptoms and dyskinesia with involuntary movements--a state difficult to manage. Different pharmacological as well as non-pharmacological strategies are used and being tried. One of these is targeting the dysfunctioning glutamatergic neurotransmitter system through the NMDA-receptors. The NMDA-receptor antagonist amantadine has long been used as an anti-Parkinson drug but also as an anti-dyskinetic drug. Recently, another NMDA-receptor antagonist, memantine, was approved for moderate to severe Alzheimer's dementia in Sweden. We describe the use of memantine on three cognitively impaired, dyskinetic Parkinsonian patients where two seemed to benefit from this medication regarding their dyskinesia. Pub-Med PMID: 15232837 ##### Effect of riluzole on dyskinesia and duration of the on state in Parkinson disease patients: a double-blind, placebo-controlled pilot study.(2004) Braz CA, Borges V, Ferraz HB. Movement Disorders Unit, Department of Neurology, Universidade Federal de Sao Paulo, Brazil. The objective of this study was to evaluate the effect of riluzole on dyskinesia and the duration of the ON state in patients with Parkinson disease (PD). The authors studied 16 PD patients with levodopa-induced dyskinesia. All patients initially received an apomorphine dose intended to induce the motor function benefit (ON state) generally accompanied by dyskinesia. They evaluated the patients during the OFF and ON states using the UPDRS-III, UPDRS-IV, and Larsen scales, and measured the duration of the ON state. Patients were randomly assigned to receive either riluzole (50 mg bid) or placebo for 7 consecutive days (8 patients in each group). The authors did not interrupt previously prescribed medication. Following the 7-day period, they carried out similar evaluation procedures before and after another apomorphine challenge. Mean UPDRS-IV scores were 6.1 points and 6.0 points before and after riluzole therapy respectively. For the placebo group, the scores were 6.9 points and 6.6 points for the initial and final evaluations respectively. Larsen scale had mean scores of 9.2 points and 9.9 points for the pre- and postriluzole periods, and 10.2 points and 9.6 points for pre- and post-placebo evaluations respectively. The ON state was 33.5% lengthier after 7 days of riluzole and 28.0% lengthier after placebo. They could not find any statistical differences between the 2 groups. Short-term riluzole administration in PD patients was not able to reduce apomorphine-induced dyskinesia but could extend the ON state duration, although this did not reach statistical significance. PMID: 15090933 #### Tetrabenazine (2005) Tetrabenazine is available in some European markets and Australia as XENAZINE(R) and in Canada as NITOMAN(R) for the treatment of hyperkinetic movement disorders. Although currently an investigational drug in the U.S., tetrabenazine can have a profound effect on chorea, with many patients demonstrating marked to good improvement. Side effects can include drowsiness, insomnia, akathisia and depression. Prestwick Pharmaceuticals Prestwick Pharmaceuticals, Inc. is an emerging specialty pharmaceutical company that focuses on treatments for CNS disorders. The company has multiple product candidates in clinical development for Huntington's Disease, Parkinson's disease and schizophrenia. Prestwick recently announced positive Phase III results of the investigational drug tetrabenazine for chorea associated with Huntington's Disease. The company anticipates filing a New Drug Application (NDA) for tetrabenazine with the U.S. Food and Drug Administration (FDA) in the near future. Prestwick was granted both fast track and orphan designation by the FDA for tetrabenazine as a therapy for chorea associated with Huntington's Disease. # # # Source: 9th International Congress of Parkinson's Disease Peggy ----- Original Message ----- From: Hilary Blue To: [log in to unmask] Sent: Tuesday, March 15, 2005 8:26 AM Subject: Re: (my progress report) / AMANTADINE... ? / calibration Ariela, About six years ago,, my dyskinesia became so bad that I volunteered for DBS surgery - then still in the pre-trial phase. But before my turn came, I read on this list about someone who took amantadine and how it almost miraculously cured his dyskinesia. I persuaded my doctor to let me try it, and within 24 hours I no longer matched the requirements for volunteering for the DBS trial! Now, 6 years later, it is losing its effect, and I am left with increasing dyskinesias and dystonias. I have taken every PD medication that there is, and the best response was with amantadine. Until recently I was taking eldepryl too, but that seemed to lose its effect, so I am sticking to my sinemet and amantadine and eagerly waiting to see what is new coming down the pipeline. (Rasagaline, do I hear you?) hilary blue ariela wrote: >rick, > >a new movement disorder neurologist we've now been seeing at mount sinai in new york has told us that amantadine is the drug of choice for dealing with dyskinesia. it's the first i hear this take about this little-used drug.... but we're still keeping this option open as my PWP is now trying stalevo (after 4 years on sinemet + requip). he's having an awful time just getting calibrated -- he moves instantaneously between long and painful freezes to awful states of badly spastic dyskinesia. there's just never a simple 'quiet,' 'calibrated' time. it goes without saying that the dosages and frequency have been tweaked and re-tweaked, to not much avail... :( > >does it sound familiar to you, or anyone on the list? can anyone please share what you do/have done/know about it? ( > >many thanks, >ariela > >==== > >>But I just figure it might be worth a little extra pain in order to put off those nasty >>diskenesias.... >> >>Enjoy! >>Rick McGirr >> > >---------------------------------------------------------------------- >To sign-off Parkinsn send a message to: mailto:[log in to unmask] >In the body of the message put: signoff parkinsn > ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn