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Amantadine for levodopa-induced dyskinesias: a 1-year follow-up study.

BACKGROUND: In a recent acute study, amantadine was found to have
antidyskinetic effect against levodopa-induced motor complications in
patients with Parkinson disease.

The longevity of this effect was not
addressed but is of interest in light of the controversy in the literature
regarding the duration of amantadine's well-established antiparkinsonian
action.

OBJECTIVE: To determine the duration of the antidyskinetic effect of
amantadine in advanced Parkinson disease.

DESIGN: One year after completion
of an acute, double-blind, placebo-controlled, crossover study, patients
returned for re-evaluation of motor symptoms and dyskinesias using a
nonrandomized, double-blind, placebo-controlled follow-up paradigm.

SETTING:
National Institutes of Health Clinical Center.

PATIENTS: 17 of the
original 18 patients with advanced Parkinson disease complicated by
dyskinesias and motor fluctuations participated in this study; 1 was lost to
follow-up.

13 of the 17 individuals had remained on amantadine therapy
for the entire year.

INTERVENTIONS: Ten days prior to the follow-up
assessment, amantadine was replaced with identical capsules containing
either amantadine or placebo.

MAIN OUTCOME MEASURES: Parkinsonian symptoms
and dyskinesia severity were scored using standard rating scales, while
subjects received steady-state intravenous levodopa infusions at the same
rate as 1 year earlier.

RESULTS: One year after initiation of amantadine
cotherapy, its antidyskinetic effect was similar in magnitude (56% reduction
in dyskinesia compared with 60% 1 year earlier).

Motor complications
occurring with the patients' regular oral levodopa regimen also remained
improved according to the Unified Parkinson's Disease Rating Scale
(UPDRS-IV).

CONCLUSION: The beneficial effects of amantadine on motor
response complications are maintained for at least 1 year after treatment
initiation.

Arch Neurol 1999 Nov;56(11):1383-6
Metman LV, Del Dotto P, LePoole K, Konitsiotis S, Fang J, Chase TN
National Institutes of Health, Bethesda, MD 20892-1406, USA.
PMID: 10555659, UI: 20022585

<http://www.ncbi.nlm.nih.gov/PubMed/>

janet paterson
52 now / 41 dx / 37 onset
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