Long-term antidyskinetic efficacy of amantadine in Parkinson's disease.
Several randomized placebo-controlled trials have consistently shown antidyskinetic effects of amantadine in levodopa treated patients with advanced Parkinson's disease (PD). However, all of these were of short duration and there have been claims that the effect of amantadine on levodopa induced dyskinesias (LID's) wear off after about 9 months of treatment. This randomized placebo-controlled parallel-group study was performed to assess the long-term antidyskinetic effect of amantadine in 32 PD patients, who after having been on stable amantadine therapy for LID over at least one year- were switched in a double blind manner to amantadine or placebo and followed for 3 weeks. Dyskinesia duration and intensity were assessed by UPDRS IV items 32 and 33 as well as by patient's diaries. The primary outcome was the score change of UPDRS IV items 32 + 33 between baseline and 3 weeks after treatment as well as the between treatment group comparison of the score change of UPDRS IV items 32 + 33. There was a significant increase of UPDRS IV items 32 + 33 in patients treated with placebo from 3.06 (95% CI, 2.1-4.03) at baseline to 4.28 (95% CI, 3.1-5.4) at three-week follow-up (P = 0.02) compared with no significant change between baseline 3.2 (95% CI, 2.1-4.4) to follow-up 3.6 (95% CI, 2.3-4.8) in patients staying on amantadine. These findings argue for long-term antidyskinetic efficacy of amantadine in PD patients with LID's.
Wolf
Elisabeth
E
Department of Neurology, Medical University Innsbruck, Innsbruck, Austria.
Seppi
Klaus
K
Katzenschlager
Regina
R
Hochschorner
Guenter
G
Ransmayr
Gerhard
G
Schwingenschuh
Petra
P
Ott
Erwin
E
Kloiber
Iris
I
Haubenberger
Dietrich
D
Auff
Eduard
E
Poewe
Werner
W
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000547:Amantadine / Q000627:therapeutic use*; D000978:Antiparkinson Agents / Q000627:therapeutic use*; D004311:Double-Blind Method; D004409:Dyskinesia, Drug-Induced / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D006801:Humans; D007980:Levodopa / Q000009:adverse effects; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy*; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000978:Antiparkinson Agents; D007980:Levodopa; D000547:Amantadine