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AMANTADINE THERAPY IN PARKINSONISM

The effect of amantadine in the treatment of parkinsonism was evaluated in three separate studies: (1) In an open pilot study with 10 patients in whom previous anticholinergic drugs had been withdrawn, definite improvement was seen in 8 patients. The optimum daily dose was 250–300 mg. The addition of previous medication to this regimen resulted in little if any further improvement. (2) In a double‐blind cross‐over study 200 mg amantadine daily was compared with placebo in 27 patients, who continued previous anticholinergic therapy. A difference in favour of amantadine was found for most parameters. The improvement was highly significant among the more disabled patients and less pronounced in those with milder symptoms. (3) In a long‐term study 17 patients were followed for up to one year during which they were treated with amantadine in combination with previous drugs. The initial benefit of amantadine was sustained in the majority of these patients during the period of observation. The EEG patterns changed during amantadine therapy with a decrease of slow activity in the abnormal records, whereas the normal ones showed an increase of alpha‐frequency and of beta‐activity. Side‐effects were few and mild. Ankle oedema was noted in about half of the patients after some months, and mild hallucinations occurred infrequently, but only when amantadine was combined with anticholinergic drugs. The effect of amantadine is prompt and exceeds that of anticholinergic drugs, but the initial benefit tends to decline in some patients.