Treatment of Parkinson's Disease With Amantadine and Levodopa

Parkes, J. D.; Curzon, G.; Knott, P. J.; Tattersall, R. B.; Baxter, R.C.; Knill‐Jones, R. P.; Marsden, C. D.; Vollum, Dorothy I.

doi:10.1016/s0140-6736(71)91834-4

Cited by 66 publications

(23 citation statements)

References 15 publications

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“…463 Amantadine has been shown to improve akinesia, rigidity, and tremor in placebo-controlled trials when used as monotherapy or in combination with levodopa. [464][465][466] In one study, amantadine was found to be more effective than anticholinergic drugs with regard to akinesia and rigidity, but it seems to be less effective with respect to tremor. 467 Early studies suggested that benefit with amantadine is transient, but some patients enjoy more sustained benefits.…”

Section: Modest Antiparkinsonian Effectmentioning

confidence: 99%

The scientific and clinical basis for the treatment of Parkinson disease (2009)

Olanow¹,

Stern²,

Sethi³

2009

Neurology

760

658

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Parkinson disease (PD) is an age-related neurodegenerative disorder that affects as many as 1-2% of persons aged 60 years and older. With the aging of the population, the frequency of PD is expected to increase dramatically in the coming decades. Current therapy is largely based on a dopamine replacement strategy, primarily using the dopamine precursor levodopa. However, chronic treatment is associated with the development of motor complications, and the disease is inexorably progressive. Further, advancing disease is associated with the emergence of features such as freezing, falling, and dementia which are not adequately controlled with dopaminergic therapies. Indeed, it is now appreciated that these nondopaminergic features are common and the major source of disability for patients with advanced disease. Many different therapeutic agents and treatment strategies have been evaluated over the past several years to try and address these unmet medical needs, and many promising approaches are currently being tested in the laboratory and in the clinic. As a result, there are now many new therapies and strategic approaches available for the treatment of the different stages of PD, with which the treating physician must be familiar in order to provide patients with optimal care. This monograph provides an overview of the management of PD patients, with an emphasis on pathophysiology, and the results of recent clinical trials. It is intended to provide physicians with an understanding of the different treatment options that are available for managing the different stages of the disease and the scientific rationale of the different approaches. 1 PD is the second most common neurodegenerative disorder, with an average age at onset of about 60 years. An estimated 5 million people throughout the world have PD, with 1 million individuals each in the United States and in Europe with the disorder. PD affects approximately 0.3% of the population and 1% to 2% of those older than 60 years.2 With the aging of the population and the substantial increase in the number of at-risk individuals older than 60 years, it is anticipated that the prevalence of PD will increase dramatically in the coming decades.

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Section: Modest Antiparkinsonian Effectmentioning

confidence: 99%

The scientific and clinical basis for the treatment of Parkinson disease (2009)

Olanow¹,

Stern²,

Sethi³

2009

Neurology

760

658

View full text Add to dashboard Cite

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“…AADC inhibitors allowed for the reduction of L-DOPA doses, a faster onset of an antiparkinsonian benefit, and a decrease in side effects of dopamine on the cardiovascular and gastrointestinal systems (Cotzias et al, 1969b;Anonymous, 1974). However, shortly after the introduction of L-DOPA as a therapy for PD, motor complications such as dyskinesia and wearingoff were observed following repeated administration of the dopamine precursor (Barbeau, 1971;Parkes et al, 1971;Weiss et al, 1971;Marsden et al, 1973a,b). In a recent community-based study, the mean time to onset of dyskinesia was 6.6 years (Evans et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

The Pharmacology of l-DOPA-Induced Dyskinesia in Parkinson’s Disease

Huot

Johnston²,

Koprich³

et al. 2013

Pharmacol Rev

288

230

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“…Results of the present double-blind and non-blind trials are in good agreement with other studies showing that amantadine produces signifi cant improvement in a certain proportion of parkinsonian patients F ieschi et ai, 1970;G illigan et al, 1970;H unt er el al., 1970;M illac el al., 1970;Parkes et al, 1970;R ao and Pearce, 1971;G o d w in -A usten et al, 1970;Schwab and E ngland, 1969;Barbeau et al, 1971;Parkes et al, 1971;Scorn, 1970], Fur thermore 4 months duration of treatment showed that it is also effective in long-term treatment. Usefulness of amantadine in the treatment of parkinsonism increases the demonstrated fact shown in all clinical trials that amantadine is relatively well tolerated.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Parkinson’s Disease with Amantadine and L-Dopa

1972

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Treatment of Parkinson’s disease with amantadine and L-dopa was studied in 82 patients. A double-blind cross-over trial with 38 patients showed a significant benefit with 200 mg of amantadine daily. During non-blind treatment with 300 mg of amantadine for 2–4 months 60% of the patients showed moderate or marked overall improvement. The results were independent of age, sex, duration or severity of the disease or previous thalamotomy. During combined treatment an additive effect of L-dopa, but not that of amantadine, was demonstrated showing that the therapeutic effect of L-dopa is superior to that of amantadine. Furthermore, an increased number of clinical side-effects, especially nausea and vomiting were found during combined treatment. Moreover, the response to L-dopa could not be predicted with amantadine. Amantadine treatment did not induce changes in the concentration of HVA and 5-HIAA in the CSF although there is a strong evidence of a monoamine-releasing effect of amantadine on experimental animals.

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Treatment of Parkinson's Disease With Amantadine and Levodopa

Cited by 66 publications

References 15 publications

The scientific and clinical basis for the treatment of Parkinson disease (2009)

The scientific and clinical basis for the treatment of Parkinson disease (2009)

The Pharmacology of l-DOPA-Induced Dyskinesia in Parkinson’s Disease

Treatment of Parkinson’s Disease with Amantadine and L-Dopa

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