Amantadine curbs weight gain with psychiatric drug

• Neurology • Sep 17, 2005



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Amantadine (Symmetrel, Endantadine), a drug used to treat Parkinson’s disease as well as the flu, may help stabilize weight in patients taking the antipsychotic drug olanzapine (Zyprexa), researchers report in the American Journal of Psychiatry.

Dr. Karen A. Graham and colleagues from the University of North Carolina, Chapel Hill, note that weight gain “is the most important tolerability issue” for antipsychotics, such as olanzapine.

To investigate whether amantadine might combat such weight increase, the researchers randomly selected 21 psychiatric patients who had gained at least 5 lbs. with olanzapine to also receive amantadine or inactive “placebo”.

The researchers assessed body mass index (BMI), a measure of body weight relative to height, as well as psychiatric status and fasting blood sugar levels when the study began and at 12 weeks.

Prior to the study, each patient had been treated with olanzapine for around 7 months. When the study began, the average BMI in each group was about 32, indicating that the subjects were generally overweight. Three patients in the amantadine group and none in the placebo group withdrew from the study.

Parkinson’s disease is a disease of the central nervous system that causes problems with body motions, including tremor (shakiness), rigidity (muscle stiffness), slowed body movements, unstable posture and difficulty walking. It happens when nerve cells (neurons) in a part of the brain called the substantia nigra gradually die. These cells normally produce dopamine, a chemical that helps to relay messages between areas of the brain that control body movement. The death of cells in this area of the brain leads to abnormally low levels of dopamine, which makes it difficult for a person with Parkinson’s disease to control muscle tension and muscle movement, both at rest and during periods of activity.

Significantly fewer patients in the amantadine group gained weight compared to the placebo group. The amantadine patients lost 0.8 lbs., on average, and had a drop in BMI of 0.07, the placebo patients gained 8.7 lbs. and had a BMI increase of 1.24.

Overall, weight stabilization or loss was seen in 67 percent of the amantadine-treated patients compared with just 22 percent of those given placebo.

The researchers note that the mechanism by which amantadine stabilizes weight is unknown, but that prevention of antipsychotic-related Obesity is critical.

“Investigation of the use of amantadine started concurrently with antipsychotic medication is imperative,” they conclude.

SOURCE: American Journal of Psychiatry, September 2005.

Provided by ArmMed Media
Revision date: June 11, 2011
Last revised: by David A. Scott, M.D.



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