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Abstract

CASE REPORT ON AMANTADINE WITHDRAWAL SYNDROME

Ajay Sairaj Asokan*, Sandhiya Kannan, Bissy Babu Tressa, Jenipher Sweetlin Joseph, Infant Smily Alphonse, Subadhra Devi J. and Venkatanarayanan R.

Abstract

Amantadine is usually utilized in addition to dopaminergic substances like dopamine agonists or Levodopa in advanced Parkinson’s disease (PD). However, adverse effects are common like hallucinations and delirium. Amantadine withdrawal syndrome (AWS) may be a rare adverse event that will present even in PD patients with cognitive impairment. Amantadine withdrawal could also be under-recognized by psychological state clinicians, which has the potential to steer to protracted hospital courses and suboptimal outcomes. Here, we report the case of a 76-year-old Parkinson’s disease patient with previously known cognitive impairment. She presented with drug-withdrawal psychotic symptoms due to changes in her therapeutic regimen based on MMSE Score (newly introduced DOPAMINE PRECURSOR). Also, amantadine had been a part of her long-term medication for quite 2 years. The severity of her psychotic symptoms required LDopa monotherapy. After changing her medication, the patient developed severe delirium that resolved rapidly after i.v. amantadine infusion, suggesting an amantadine withdrawal syndrome. This case report highlights the necessity for a gradual withdrawal of amantadine albeit acute and severe psychotic symptoms are present.

Keywords: Amantadine withdrawal syndrome, Parkinson’s disease, Hallucination, MMSE score.


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