A Case Report of Severe Delirium after Amantadine Withdrawal

Marxreiter F, Winkler J, Uhl M, Madzar D (2017)


Publication Type: Journal article

Publication year: 2017

Journal

Book Volume: 9

Pages Range: 44-48

Journal Issue: 1

DOI: 10.1159/000460814

Abstract

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.

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APA:

Marxreiter, F., Winkler, J., Uhl, M., & Madzar, D. (2017). A Case Report of Severe Delirium after Amantadine Withdrawal. Case Reports in Neurology, 9(1), 44-48. https://doi.org/10.1159/000460814

MLA:

Marxreiter, Franz, et al. "A Case Report of Severe Delirium after Amantadine Withdrawal." Case Reports in Neurology 9.1 (2017): 44-48.

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