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Amantadine is a tricyclic amine which is used in the treatment of parkinsonism. It has direct and indirect effects on dopamine neurons. Recent studies have demonstrated that amantadine is a weak, non-competitive NMDA receptor antagonist. (1)

Treatment of parkinsonism and drug-induced extrapyramidal reactions. (2)

hypersensitivity to amantadine hydrochloride. (2)

nausea, dizziness and insomnia depression, anxiety and irritability, hallucinations, confusion, anorexia, dry mouth, constipation, ataxia, livedo reticularis, peripheral edema, orthostatic hypotension, headache, somnolence, nervousness, dream abnormality, agitation, dry nose, diarrhea and fatigue Death due to acute anticholinergic activity. Suicide attempts Seizures congestive heart failure Neuroleptic malignant syndrome Increased association with melanoma (2)

Anti-cholinergic drugs: Potentiation of their effects Thioridazine: Worsening of tremors Quinine and quinidine: reduced renal clearance of amantadine Live attenuated influenza vaccine: Amantadine should not be administered within 2 weeks before or 48 hours after vaccine (2)

Excreted in human milk, hence use is not recommended in nursing mothers Safety is not established <1years of age Elderly have decreased renal function which might result in increased incidence of toxicity in these patients. (2)

Dosage for Parkinsonism 100 mg twice a day when used alone. It can be increased to 400 mg daily in divided doses Dosage for Drug-Induced Extrapyramidal Reactions 100 mg twice a day. It can be increased to 300 mg daily in divided doses (2)

1. Brunton LL, Chabner BA, Knollmann BC, editors. Goodman & Gilman’s The Pharmacological Basis of Therapeutics. 12th ed. China: McGraw Hill; 2011. 2. Symmetrel [cited 2013 Aug 25]. Available from:,018101s016lbl.pdf