Amantadine and the end-stage dementia of Alzheimer's type

Significant improvement of mental status was noted with amantadine therapy in three patients in whom autopsy subsequently showed Alzheimer's disease. Two patients showed a dramatic improvement during the treatment. Their mute, immobile states were reversed and they were able to speak a few coherent words. Their mental status deteriorated when the drug was withdrawn. Transient clinical improvement was noted when amantadine was reinstituted. In all patients EEG showed typical repetitive periodic sharp waves (PSW) similar to those seen in Creutzfeldt-Jacob disease. Alterations of PSW accompanied the initial clinical improvement. We speculate that amantadine acts as a central stimulant by enhancing the release of central endogenous dopamine and possibly other neurotransmitters.