How does amantadine help in Parkinson’s disease?

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How does amantadine help in Parkinson’s disease?

Amantadine is a medication used in Parkinson’s disease for its unique ability to address several motor symptoms, particularly dyskinesia, which is an involuntary movement disorder often induced by long-term use of levodopa. Here’s how amantadine helps in Parkinson’s disease:

1. Reduction of Dyskinesia

Primary Use: Amantadine is particularly effective in reducing levodopa-induced dyskinesia, which can be a significant issue for Parkinson’s patients after long-term use of levodopa.
Mechanism: Amantadine is thought to work by modulating the activity of glutamate, an excitatory neurotransmitter in the brain. By blocking NMDA (N-methyl-D-aspartate) receptors, which are involved in glutamate signaling, amantadine reduces the overactivity that contributes to dyskinesia.

2. Alleviation of Motor Symptoms

Dopaminergic Effects: Amantadine also has mild dopaminergic effects, meaning it increases dopamine release and inhibits its reuptake. This action helps improve symptoms such as bradykinesia (slowness of movement), rigidity, and tremors in Parkinson’s disease, although it is generally less potent than drugs like levodopa or dopamine agonists.
Antiviral Properties: Originally, amantadine was developed as an antiviral drug, but its beneficial effects on Parkinson’s symptoms were discovered later. Its impact on dopamine and glutamate systems contributes to its effectiveness in this role.

3. Neuroprotective Potential

Theoretical Benefit: Some research suggests that amantadine might have neuroprotective properties due to its NMDA receptor antagonist activity, potentially reducing excitotoxicity, which is a process that can lead to nerve cell damage or death. However, this potential benefit is still under investigation and not definitively proven.

4. Multifaceted Action

Combination Therapy: Amantadine is often used in combination with other Parkinson’s medications to enhance overall symptom control. For instance, it might be added to a regimen involving levodopa to help reduce the occurrence and severity of dyskinesia.

5. Side Effects and Considerations

Common Side Effects: While amantadine is beneficial, it can cause side effects such as confusion, hallucinations, dry mouth, and livedo reticularis (a mottled skin condition).
Patient Suitability: Amantadine is often more suitable for younger patients or those who specifically need dyskinesia management, as older patients may be more susceptible to its cognitive side effects.

Conclusion

Amantadine plays a valuable role in managing Parkinson’s disease by addressing dyskinesia, improving motor symptoms, and potentially offering neuroprotective benefits. It is particularly useful in patients who experience motor complications from long-term levodopa therapy, providing a way to manage these issues and improve quality of life.

Sources:

Parkinson’s Foundation: Amantadine
Mayo Clinic: Amantadine Overview

Jodi Knapp