Role of anticholinergic drugs and amantadine in Parkinsons Disease
What is the role of anticholinergic drugs and amantadine in the treatment of Parkinsons Disease ?
In the early stages of Parkinsons Disease, anticholinergic drugs, combined with rasagiline or selegiline, may be used as the primary treatment.
With progression of disease, most patients require the addition of levodopa.
Tremor is occasionally resistant to dopaminergic therapy and may be better controlled in combination with anticholinergic medication such as trihexyphenidyl.
Amantadine, a drug that has mild anticholinergic effects and increases the release of dopamine, also improves rigidity and bradykinesia.
Furthermore, studies have revealed the utility of amantadine in reducing levodopa-induced dyskinesias (LID).
The anticholinergic medications must be used cautiously because, in addition to causing dryness of the mouth and bladder retention, they may produce disorientation, confusion, and memory loss, particularly in the elderly.
Amantadine in some patients also may cause cognitive side effects as well as livedo reticularis, hallucinations, ankle swelling, and worsening of congestive heart failure.
