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Amantadine-induced coma

G J Macchio1, V Ito, V Sahgal

  • 1Department of Rehabilitation Medicine, Northwestern University Medical School, Chicago, IL.

Archives of Physical Medicine and Rehabilitation
|October 1, 1993
PubMed
Summary
This summary is machine-generated.

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Amantadine can cause severe toxicity, including coma, especially in patients with kidney disease. This case highlights profound amantadine toxicity at a typically safe level in a patient with multiple sclerosis and end-stage renal disease.

Area of Science:

  • Neuropharmacology
  • Nephrology
  • Toxicology

Background:

  • Amantadine is an antiviral and antiparkinsonian agent with off-label uses for multiple sclerosis fatigue and traumatic brain injury agitation.
  • Central nervous system side effects include hallucinations and confusion; severe toxicity can lead to psychosis, coma, and death.

Observation:

  • A patient with multiple sclerosis and end-stage renal disease developed amantadine-induced coma.
  • The severity of the toxic presentation was notable, occurring at an amantadine drug level not typically associated with such profound effects.

Findings:

  • Amantadine toxicity is exacerbated in renal insufficiency due to its primary renal excretion.
  • This case demonstrates a critical drug interaction and patient vulnerability in managing amantadine therapy.

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Implications:

  • Highlights the need for careful dosing and monitoring of amantadine in patients with impaired renal function.
  • Underscores the potential for severe adverse events even at lower-than-expected drug concentrations in susceptible populations.
  • Emphasizes the importance of considering renal function in amantadine pharmacotherapy to prevent toxicity.