Amantadine: an old drug reborn

[...]pivotal trials have demonstrated that amantadine ADS-5102 release can improve dyskinesia, reduce off time, and increase on time without troublesome dyskinesia.3,4 The Personal View gives the reader an understanding of the use of amantadine in clinical practice. Additionally, a post hoc analysis of the EASE LID 2 study6 in patients with Parkinson's disease with levodopa-induced dyskinesia who switched from immediate-release amantadine to amantadine ADS-5102 suggested that amantadine ADS-5102 provided incremental benefit when compared with immediate-release amantadine.7 These data raise the possibility that the different pharmacokinetic profile of amantadine ADS-5102 might confer additional benefis.8 Another important question is whether early use of amantadine would delay the onset of off time and dyskinesia, which might be answered soon by the Amantadine and L-DOPA-induced Dyskinesia in Early Parkinson's Disease (PREMANDDYSK) trial (NCT01538329). A major concern regarding the use of amantadine is the risk of adverse events, especially hallucinations.4 As Rascol and colleagues discuss, amantadine is primarily excreted by the kidneys.