Amantadine in parkinson’s disease: modern possibilities of long-term therapy

Abstract

The long-term therapy of Parkinson’s disease (PD) with dopaminergic drugs is naturally accompanied by the fluctuations in symptoms and dyskinesia, and these complications are an extremely important factor that adversely affects the quality of life. The hyperactivity of glutamate NMDA receptors of the striatum plays an important role in the pathophysiology of medicinal dyskinesia, so the use of anti-glutamatergic agents, primarily amantadine, is currently the common method of combating dyskinesia. This article summarizes the current understanding of the mechanisms of action and the clinical effects of amantadine derivatives in patients with different stages of PD, with an emphasis on the antidiskinetic effect of this group of antiparkinsonian agents. It also presents the advantages of amantadine sulphate (PK-Merz) over other dosage forms (pharmacokinetics, duration of effect, tolerability, possibility of intravenous infusion administration), including those in the treatment of acute decompensation of PD.