• Meir Kestenbaum, Muneer Abu Snineh, Tamar Nussbaum, Avi Gadoth, Alina Rosenberg, Avigail Hindi, Jennifer Zitser, Avner Thaler, Nir Giladi, and Tanya Gurevich.
• Department of Neurology, Meir Medical Center, Kfar Saba, Israel.
• Isr Med Assoc J. 2019 Dec 1; 21 (12): 812-816.

BackgroundThe effect of repeated intravenous amantadine (IVAM) in advanced Parkinsonism has not been studied in depth.ObjectivesTo report the experience of our medical center with repeated IVAM infusions in patients with advanced Parkinsonism.MethodsThirty patients with advanced Parkinsonism of various etiologies were enrolled in an open-label retrospective study. All patients were treated with IVAM infusions in a neurological daycare center. Treatment was initiated with a loading dose of 200/400 mg per day for 5 days followed by a once-daily maintenance dose of 200/400 mg every 1 to 3 weeks. Patients and their caregivers participated in a structured interview and independently completed a clinical global impression of changes scale questionnaire on various motor and non-motor symptoms.ResultsPatient mean age was 73.3 ± 9.7 years, average disease duration was 6.2 ± 5.7 years, and mean Hoehn and Yahr score was 3.2 ± 0.84. Mean duration of the IVAM treatment was 15.1 ± 11.6 months. An improvement in general function was reported by 91% of the patients and 89% of the caregivers. Most of the patients reported improvement in tremor and rigidity, as well as in gait stability, freezing of gait, and reduced falls. The treatment was safe with few side effects.ConclusionsOur data suggest that repeated IVAM infusions could be an effective treatment against various motor symptoms and for improvement of mobility in patients with advanced Parkinsonism. Further randomized clinical trials with a larger sample size using objective measures are warranted to validate our results.

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