Amantadine for dyskinesias in Parkinson's disease: a randomized controlled trial

• Published in: PloS one 2010-12, Vol.5 (12), p.e15298-e15298
• Main Authors: Sawada, Hideyuki, Oeda, Tomoko, Kuno, Sadako, Nomoto, Masahiro, Yamamoto, Kenji, Yamamoto, Mitsutoshi, Hisanaga, Kinya, Kawamura, Takashi
• Format: Article
• Language: English
• Subjects: Adult; Aged; Amantadine; Amantadine - pharmacology; Analysis; Antiparkinson Agents - pharmacology; Behavior disorders; Bioethics; Biology; Brain research; Care and treatment; Clinical Trial; Clinical trials; Complications; Confidence intervals; Cross-Over Studies; Disease control; Dopamine; Double-Blind Method; Drug dosages; Dyskinesia; Dyskinesias - drug therapy; Ethics; Female; Hospitals; Human motion; Humans; Male; Medical research; Medicine; Middle Aged; Movement disorders; Neurodegenerative diseases; Neurology; Parkinson Disease - drug therapy; Parkinson's disease; Parkinsons disease; Patients; Placebos; Psychosis; Quality; Quality of Life; Randomization; Variation; Washout
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0015298

Dyskinesias are some of the major motor complications that impair quality of life for patients with Parkinson's disease. The purpose of the present study was to investigate the efficacy of amantadine in Parkinson's disease patients suffering from dyskinesias. In this multi-center, double-blind, randomized, placebo-controlled, cross-over trial, 36 patients with Parkinson's disease and dyskinesias were randomized, and 62 interventions, which included amantadine (300 mg/day) or placebo treatment for 27 days, were analyzed. At 15 days after washout, the treatments were crossed over. The primary outcome measure was the changes in the Rush Dyskinesia Rating Scale (RDRS) during each treatment period. The secondary outcome measures were changes in the Unified Parkinson's Disease Rating Scale part IVa (UPDRS-IVa, dyskinesias), part IVb (motor fluctuations), and part III (motor function). RDRS improved in 64% and 16% of patients treated with amantadine or placebo, respectively, with significant differences between treatments. The adjusted odds-ratio for improvement by amantadine was 6.7 (95% confidence interval, 1.4 to 31.5). UPDRS-IVa was improved to a significantly greater degree in amantadine-treated patients [mean (SD) of 1.83 (1.56)] compared with placebo-treated patients [0.03 (1.51)]. However, there were no significant effects on UPDRS-IVb or III scores. Results from the present study demonstrated that amantadine exhibited efficacious effects against dyskinesias in 60-70% of patients. UMIN Clinical Trial Registry UMIN000000780.