Background: Recent short-term studies suggested that Amantadine (Ama) might ameliorate dyskinesias in Parkinson’s Disease patients. A double-blind study programmed over a 12 months period was designed in order to assess the duration of the antidyskinetic effect of amantadine on levodopa-induced dyskinesias. Methods: 40 patients treated for 7.5±2.2 years with levodopa (729.3±199.4mg/day) and dopaminoagonists, complaining of peak-dose and/or dyphasic dyskinesias with or without pain, were assessed with UPDRS subscale IV Item 32-34, the Dyskinesias Rating Scale (DRS) and Investigator Global Assessment (IGA). 20 patients received amantadine - chloridrate (100 mg) and 20 placebo, titrated to 1 capsule three times per day. Ama or placebo could be withdrawn, when scores indicated worsening of dyskinesias upon agreement with the patient. Statistical analyses were performed with ANOVA, Student’s t test and Kaplan-Meier curves. Results: After 15 days of amantadine treatment a significant reduction by 45% in the total dyskinesias scores was observed. All patients of the placebo group were withdrawn from the study in 1-3 months and all patients of the Ama group were withdrawn from the study in 3-8 months (p=0.01, p<0.001). Ama withdrawal induced a rebound with increment of dyskinesias by 10-20% in 11 patients. Conclusion: Our results show that 300 mg amantadine reduces dyskinesias in PD by approximately 45% but the benefit lasted less than 8 months.
Duration of Amantadine benefit on dyskinesias of severe Parkinson’s Disease.
THOMAS, Astrid Maria;DI IORIO, Angelo;ONOFRJ, Marco
2004-01-01
Abstract
Background: Recent short-term studies suggested that Amantadine (Ama) might ameliorate dyskinesias in Parkinson’s Disease patients. A double-blind study programmed over a 12 months period was designed in order to assess the duration of the antidyskinetic effect of amantadine on levodopa-induced dyskinesias. Methods: 40 patients treated for 7.5±2.2 years with levodopa (729.3±199.4mg/day) and dopaminoagonists, complaining of peak-dose and/or dyphasic dyskinesias with or without pain, were assessed with UPDRS subscale IV Item 32-34, the Dyskinesias Rating Scale (DRS) and Investigator Global Assessment (IGA). 20 patients received amantadine - chloridrate (100 mg) and 20 placebo, titrated to 1 capsule three times per day. Ama or placebo could be withdrawn, when scores indicated worsening of dyskinesias upon agreement with the patient. Statistical analyses were performed with ANOVA, Student’s t test and Kaplan-Meier curves. Results: After 15 days of amantadine treatment a significant reduction by 45% in the total dyskinesias scores was observed. All patients of the placebo group were withdrawn from the study in 1-3 months and all patients of the Ama group were withdrawn from the study in 3-8 months (p=0.01, p<0.001). Ama withdrawal induced a rebound with increment of dyskinesias by 10-20% in 11 patients. Conclusion: Our results show that 300 mg amantadine reduces dyskinesias in PD by approximately 45% but the benefit lasted less than 8 months.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
