A Case Report of Severe Delirium after Amantadine Withdrawal
Amantadine is frequently used in addition to dopaminergic substances like dopamine agonists or L-Dopa in advanced Parkinson disease (PD). However, adverse effects like hallucinations limit its use. PD patients developing severe psychotic symptoms upon treatment with either dopaminergic substances an...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Karger Publishers
2017-03-01
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| Series: | Case Reports in Neurology |
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| Online Access: | http://www.karger.com/Article/FullText/460814 |
| _version_ | 1819261773709049856 |
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| author | Franz Marxreiter Jürgen Winkler Martin Uhl Dominik Madžar |
| author_facet | Franz Marxreiter Jürgen Winkler Martin Uhl Dominik Madžar |
| author_sort | Franz Marxreiter |
| collection | DOAJ |
| description | Amantadine is frequently used in addition to dopaminergic substances like dopamine agonists or L-Dopa in advanced Parkinson disease (PD). However, adverse effects like hallucinations limit its use. PD patients developing severe psychotic symptoms upon treatment with either dopaminergic substances and/or amantadine need to stop intake of any psychotropic substance. Here, we report the case of a 71-year-old PD patient without previously known cognitive impairment. He presented with drug-induced psychotic symptoms due to changes in his therapeutic regimen (increase in COMT inhibitors, newly introduced MAO B inhibitors). Also, amantadine had been part of his long-term medication for more than 2 years. The severity of his psychotic symptoms required a L-Dopa monotherapy. After changing his medication, the patient developed severe delirium that resolved rapidly after i.v. amantadine infusion, suggesting an amantadine withdrawal syndrome. Amantadine withdrawal syndrome is a rare adverse event that may present even in PD patients without cognitive impairment. This case report highlights the need for a gradual withdrawal of amantadine even if acute and severe psychotic symptoms are present. Moreover, this is the first report of a cognitively unimpaired patient developing an amantadine withdrawal syndrome. |
| first_indexed | 2024-12-23T19:47:08Z |
| format | Article |
| id | doaj.art-395eafe4422049a09e83b2a904a29b0f |
| institution | Directory Open Access Journal |
| issn | 1662-680X |
| language | English |
| last_indexed | 2024-12-23T19:47:08Z |
| publishDate | 2017-03-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Case Reports in Neurology |
| spelling | doaj.art-395eafe4422049a09e83b2a904a29b0f2022-12-21T17:33:30ZengKarger PublishersCase Reports in Neurology1662-680X2017-03-0191444810.1159/000460814460814A Case Report of Severe Delirium after Amantadine WithdrawalFranz MarxreiterJürgen WinklerMartin UhlDominik MadžarAmantadine is frequently used in addition to dopaminergic substances like dopamine agonists or L-Dopa in advanced Parkinson disease (PD). However, adverse effects like hallucinations limit its use. PD patients developing severe psychotic symptoms upon treatment with either dopaminergic substances and/or amantadine need to stop intake of any psychotropic substance. Here, we report the case of a 71-year-old PD patient without previously known cognitive impairment. He presented with drug-induced psychotic symptoms due to changes in his therapeutic regimen (increase in COMT inhibitors, newly introduced MAO B inhibitors). Also, amantadine had been part of his long-term medication for more than 2 years. The severity of his psychotic symptoms required a L-Dopa monotherapy. After changing his medication, the patient developed severe delirium that resolved rapidly after i.v. amantadine infusion, suggesting an amantadine withdrawal syndrome. Amantadine withdrawal syndrome is a rare adverse event that may present even in PD patients without cognitive impairment. This case report highlights the need for a gradual withdrawal of amantadine even if acute and severe psychotic symptoms are present. Moreover, this is the first report of a cognitively unimpaired patient developing an amantadine withdrawal syndrome.http://www.karger.com/Article/FullText/460814Parkinson diseaseAmantadine withdrawalPsychotic symptomsDeliriumAmantadine |
| spellingShingle | Franz Marxreiter Jürgen Winkler Martin Uhl Dominik Madžar A Case Report of Severe Delirium after Amantadine Withdrawal Case Reports in Neurology Parkinson disease Amantadine withdrawal Psychotic symptoms Delirium Amantadine |
| title | A Case Report of Severe Delirium after Amantadine Withdrawal |
| title_full | A Case Report of Severe Delirium after Amantadine Withdrawal |
| title_fullStr | A Case Report of Severe Delirium after Amantadine Withdrawal |
| title_full_unstemmed | A Case Report of Severe Delirium after Amantadine Withdrawal |
| title_short | A Case Report of Severe Delirium after Amantadine Withdrawal |
| title_sort | case report of severe delirium after amantadine withdrawal |
| topic | Parkinson disease Amantadine withdrawal Psychotic symptoms Delirium Amantadine |
| url | http://www.karger.com/Article/FullText/460814 |
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