Rimantadine in Parkinson's disease patients experiencing peripheral adverse effects from amantadine: Report of a case series

Abstract

We report our experience with 7 consecutive patients with Parkinson's disease (PD) who received rimantadine (the alpha-methyl derivative of amantadine) in substitution of amantadine due to peripheral side effects (lower limb edema, livedo reticularis). Mean age was 67.3 +/- 5.9 years, the mean disease duration was 13 +/- 6.3 years, and mean Hoehn and Yahr stage was 2.2 +/- 0.4. A total of 3 patients experienced marked improvement of edema, and 1 patient experienced marked improvement of livedo reticularis. Only 1 of the 7 patients reported significant loss of motor benefit when amantadine was replaced with rimantadine. Our results demonstrate that rimantadine may be considered as an alternative to amantadine in patients experiencing amantadine-induced peripheral side effects.