AMANTADINE

What is Amantadine?

Amantadine is a medication used to treat abnormal movements in conditions such as Parkinson’s disease.

What does Amantadine do in the body?

Amantadine has mild effects on dopamine neurons, but we’re not sure exactly how it works for Parkinson’s. It also seems to stop a virus from infecting cells, but we don’t fully understand how it works.  While Amantadine has some antiviral properties, it is no longer recommended as an antiviral in clinical practice. [1]

How can Amantadine help alleviate certain long COVID symptoms and pathophysiology?

When it comes to long COVID, especially post-COVID-19 fatigue, there’s limited but hopeful evidence for using amantadine. One study found that patients who took amantadine for two weeks had less fatigue compared to those who didn’t, as measured by the Visual Analog Fatigue Scale (VAFS) and Fatigue Severity Scale (FSS). [2] However, other studies looked at different aspects of COVID-19 and how amantadine is used to treat it.

For example, one study found no significant improvements in fatigue among unvaccinated patients with early, mild to moderate COVID-19. [3] Another study emphasized the need for more standardized and robust studies on long COVID.[4]. The treatment has also been considered for fatigue in other conditions, such as Multiple Sclerosis. A Cochrane Database of Systematic Reviews found that amantadine is generally well-tolerated. However, the evidence supporting its effectiveness in reducing MS-related fatigue is still limited and inconsistent [5].  While Amantadine has the potential to reduce post-COVID-19 fatigue, but we need more large-scale, well-controlled studies to confirm its effectiveness and safety in this context.

1.Uyeki TM, Bernstein HH, Bradley JS, et al. Clinical Practice Guidelines by the Infectious Diseases Society of America: 2018 Update on Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management of Seasonal Influenzaa. Clinical Infectious Diseases. 2018;68(6):e1-e47. doi:10.1093/cid/ciy866

2.Harandi AA, Pakdaman H, Medghalchi A, et al. A randomized open-label clinical trial on the effect of Amantadine on post Covid 19 fatigue. Scientific Reports. 2024;14(1). doi:10.1038/s41598-024-51904-z

3Rejdak K, Fiedor P, Bonek R, et al. Amantadine in unvaccinated patients with early, mild to moderate COVID‐19: A randomized, placebo‐controlled, double‐blind trial. European Journal of Neurology. 2023;31(1). doi:10.1111/ene.16045

4.Chee YJ, Fan BE, Young BE, Dalan R, Lye DC. Clinical trials on the pharmacological treatment of long COVID: A systematic review. Journal of Medical Virology. 2022;95(1). doi:10.1002/jmv.28289