Other Medications

Key Facts

  • Amantadine often provides immediate benefit for most PD symptoms<, but its effect frequently wanes after a few weeks or months.
  • Amantadine may be particularly benefitial in people with PD who have prominent tremor or bothersome levodopa<-induced dyskinesia<.
  • Droxidopa< is used to treat neurogenic orthostatic hypotension.

Amantadine has mildly beneficial effect in PD. Currently, its primary role is to reduce levodopa< dyskinesias.

Presentation

Dosages in Milligrams

Typical Treatment Regimens

Indications for Usage

Trihexyphenidyl (formerly Artane®)

2, 5

1-2 mg 2 or 3 times daily

Monotherapy or adjunct therapy, predominantly for tremor in younger people

Benztropine (Cogentin®)

0.5, 1, 2

0.5 – 2 mg 2 or 3 times daily

Same as above

 

Prescription Recommendations

Amantadine

  • Prescribe 1 tablet in the morning and then after a week, raise the dose to 1 tab twice daily.
  • You can raise dose to 1 tablet three times daily–this is the typical dose.
  • You may go as high as 5 tablets a day.
  • Most practitioners now use it later in the course of PD for dyskinesia.
  • Cannot use if poor renal function.

Side Effects

  • Redness or reddish purple discoloration of the legs, often with swelling–if it does not bother the patient you should not be worry
  • Hallucinations
  • Confusion
References: 

Ahlskog JE. Parkinson’s Disease Treatment Guide for Physicians. New York, NY: Oxford University Press; 2009.

Ahlskog JE. The Parkinson’s Disease Treatment Book: Partnering with Your Physician to Get the Most from Your Medications. New York, NY: Oxford University Press; 2005.