Levodopa
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Levodopa Dyskinesias and on-off phenomena, treated with memantine: 3 case reports Three patients developed dyskinesias and on-off phenomena during treatment with levodopa [dosages and routes of administration not stated] for Parkinson’s disease [ages not clearly stated]. The patients were treated with memantine. Patient 1, a woman, developed peak dose choreic dyskinesias and on-off phenomena 7 years after initiating levodopa. Amantadine was administered, yet resulted in hallucinations and livedo reticularis when > 100 mg/day was prescribed, and was later withdrawn. Her on-phase dyskinesia and clinical fluctuations scores were both 4. After initiating memantine 30mg, her dyskinesia and fluctuations total scores subsequently dropped to 1. Memantine withdrawal resulted in dyskinesia progression and necessitated later reintroduction. Patient 2, a woman, developed on-off fluctuations in addition to peak dose dystonic dyskinesias, 5 years after, initiating levodopa, entacapone and amantadine. Her dyskinesia and fluctuation scores were both 4 prior to starting memantine treatment. Levodopa adjustments proved ineffective, and the memantine dose was increased to 30 mg/day. Her dyskinesia score dropped to 2; however, the fluctuations score remained the same. Patient 3, a man, initially presented with a 10-year history of Parkinson’s disease for which he was receiving levodopa and entacapone; he exhibited peak dose choreic dyskinesias and on-off fluctuations [duration of treatment prior to reaction onset not stated]. A dyskinesia score of 4 with a fluctuation score of 3 was reported. Optimisation of levodopa therapy resulted in minor amelioration. Following memantine 20 mg/day introduction, a slight improvement was noted. On memantine withdrawal, symptom progression resulted. Memantine reintroduction resulted in resolution of both the dyskinesias and fluctuations. Varanese S, et al. NMDA antagonist memantine improves levodopa-induced dyskinesias and "on-off" phenomena in Parkinson’s disease. Movement Disorders 803037798 25: 508-510, No. 4, Mar 2010 - USA
0114-9954/10/1318-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Reactions 11 Sep 2010 No. 1318
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