Original ArticlesEfficacy of Parenteral Amantadine Therapy in the Treatment of Multiple System Atrophy With Predominant ParkinsonismFriedberg, Adit MD*†; Erikh, Ilana RN‡; Nassar, Maria MD‡; Sprecher, Elliot PhD‡; Schlesinger, Ilana MD‡§Author Information From the *Department of Neurology, Tel Aviv Sourasky Medical Center; †Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv; ‡Department of Neurology, Rambam Health Care Campus; and §Technion Faculty of Medicine, Haifa, Israel. Address correspondence and reprint requests to Ilana Schlesinger, MD, Department of Neurology, Rambam Health Care Campus, PO Box 9602, Haifa 31096, Israel; E-mail: email@example.com Conflicts of Interest and Source of Funding: The authors have no conflicts of interest to declare. Clinical Neuropharmacology: 9/10 2018 - Volume 41 - Issue 5 - p 160-163 doi: 10.1097/WNF.0000000000000291 Buy Metrics Abstract Objective The aim of this study was to assess clinical response to a high-dose intravenous (IV) amantadine given for 5 consecutive days in patients with multiple system atrophy parkinsonism (MSA-P). Methods Subjects with a diagnosis of MSA-P treated with IV amantadine were included. Patients' disease severity before and after therapy was evaluated using the Unified Multiple System Atrophy Rating Scale (UMSARS). Results Fourteen subjects (8 females) were included. In 10 subjects (71.4%), clinical improvement was noted. The UMSARS score after treatment decreased by 2 points (median [interquartile range, 0–3]) when compared with UMSARS score at baseline (P = 0.0020). Upon examining the walking parameter, a trend of improvement was shown (P = 0.0625) (range, 0–1 points). Neither specific demographic parameters nor occurrence of adverse effects was found to be a predictive factor for improvement. Adverse events were mild and transient except for one patient who experienced acute psychosis prompting treatment cessation, upon which psychosis resolved. Conclusions Our preliminary data show that IV amantadine may be a safe and effective therapy in MSA-P. A double-blind placebo-controlled trial is needed to establish the true benefit of amantadine therapy. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.