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Amantadine in Parkinson's disease
N Crosby1, K H Deane, C E Clarke
1Department of Neurology, City Hospital NHS Trust, Dudley Road, Birmingham, West Midlands, UK, B18 7QH. c.e.clarke@bham.ac.uk
The Cochrane Database of Systematic Reviews
|January 22, 2003
Summary
Rigorous analysis of amantadine for Parkinson's disease shows insufficient evidence of efficacy and safety. More high-quality randomized controlled trials are needed to confirm its benefits and risks.
Area of Science:
- Neurology
- Pharmacology
Background:
- Levodopa is the primary Parkinson's disease treatment but causes side effects.
- Amantadine, an antiviral, is explored as an alternative or adjunct therapy.
- Investigating amantadine's efficacy and safety compared to placebo is crucial.
Purpose of the Study:
- To compare the efficacy and safety of amantadine (monotherapy or adjuvant) versus placebo in Parkinson's disease patients.
- To synthesize evidence from randomized controlled trials (RCTs).
Main Methods:
- Conducted comprehensive electronic database searches for RCTs.
- Included studies comparing amantadine with placebo in idiopathic Parkinson's disease.
- Independent data abstraction and resolution of disagreements.
Main Results:
- Six RCTs (215 patients) were identified, evaluating amantadine as monotherapy or adjuvant.
- Methodological limitations (bias, missing data, carry-over effects) hindered analysis.
- Reported side effects (livido reticularis, dry mouth, blurred vision) were generally not severe.
Conclusions:
- Rigorous analysis of available RCTs reveals insufficient evidence for amantadine's efficacy and safety in idiopathic Parkinson's disease.
- Existing evidence primarily stems from non-controlled trials, often in different Parkinsonian conditions.
- Further high-quality RCTs are necessary to establish amantadine's role in Parkinson's disease management.