EP 18 - Article Of The Week: Effect on Dyskinesia of the Early Combination of Amantadine to Levodopa-Therapy in Parkinson's Disease: A Randomized, Placebo-Controlled Study (PREMANDYSK)

🎙️ We’re back with the eighteenth episode of Parkinson Weekly, hosted by Prof. Bas Bloem.In this episode, Bas discusses new evidence on an old drug: amantadine. He reviews the PREMANDYSK study, a large multicentre, randomised, placebo-controlled trial conducted across 15 specialist centres in France and published in Movement Disorders, which investigated whether early use of amantadine can delay or prevent the development of levodopa-induced dyskinesias in people with Parkinson’s disease.Bas walks listeners through the study’s innovative delayed-start and washout design, explains why amantadine’s unique dopaminergic and NMDA-antagonist properties make it biologically plausible for this role, and highlights the key findings — including a 50% reduction in peak-dose dyskinesias at 18 months, lower levodopa dose escalation, and modest benefits for freezing of gait, fatigue, and quality of life, without an increase in adverse events.He also offers a balanced interpretation of what the results do — and do not — tell us about true disease modification, discusses important limitations such as follow-up duration and patient selection, and reflects on how these findings may influence clinical decision-making today. Bas closes by reappraising amantadine’s place in Parkinson’s care, particularly as an underrated, cost-effective option for the right patient, while emphasising the need for further long-term research.👉 You can read the full article here:https://pubmed.ncbi.nlm.nih.gov/41316871/Have a question you’d like Bas to answer in a future episode? Email us at [email protected] – we’d love to hear from you.