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Amantadine, used for multiple sclerosis fatigue, can cause visual hallucinations in patients with kidney impairment. Reducing amantadine dosage or stopping it resolved hallucinations in a multiple sclerosis patient with acute renal issues.

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Area of Science:

  • Neuropharmacology
  • Nephrology

Background:

  • Amantadine is an NMDA receptor agonist with dopaminergic effects, prescribed for Parkinson's disease dyskinesia and multiple sclerosis (MS) fatigue.
  • Renal excretion is the primary route for amantadine elimination; impaired kidney function can increase drug half-life and toxicity risk.

Purpose of the Study:

  • To report a case of amantadine-induced visual hallucinations in a patient with multiple sclerosis and acute renal impairment.
  • To highlight the potential for amantadine toxicity in the context of compromised kidney function.

Main Methods:

  • Case report of a female multiple sclerosis patient undergoing amantadine treatment.
  • Clinical observation of visual hallucinations coinciding with acute renal impairment.
  • Assessment of symptom resolution upon medication cessation.

Main Results:

  • The patient developed acute renal impairment while on amantadine therapy.
  • Florid visual hallucinations emerged concurrently with the renal impairment.
  • Hallucinations resolved completely after discontinuing amantadine.

Conclusions:

  • Acute renal impairment can precipitate amantadine toxicity, manifesting as severe visual hallucinations.
  • Caution is advised when prescribing amantadine to patients with compromised renal function.
  • Monitoring kidney function is crucial in patients receiving amantadine to prevent adverse events.