Amantadine

AMANTADINE

Amantadine is a medication (Symmetrel) that is believed to be an indirect Dopamine agonist; this means that it releases the neurotransmitter dopamine from nerve terminals in the brain. Since some of the symptoms of Cocaine withdrawal and cocaine dependence are thought to be related to abnormalities in the dopamine systems of the brain, and these are thought to contribute to relapse, amantadine has been examined as a treatment possibility.

After chronic cocaine use, many patients' dopamine systems either fail to release sufficient dopamine or are insensitive to the dopamine that is released. This relative dopamine deficit is believed to be responsible for the dysphoria of cocaine withdrawal. It was hoped that amantadine would relieve their dysphoria and reduce relapse back to cocaine abuse by increasing the release of dopamine in the brains of cocaine-dependent patients. Amantadine has been effective in reducing depressive symptoms in patients with neurological disorders such as Parkinson's disease, which is due to the death of dopamine-producing cells in the brain; however, no solid evidence exists that it is helpful in preventing continued cocaine use or relapse to cocaine use after detoxification.

(See also: Treatment: Cocaine ; Withdrawal: Cocaine )

Thomas R. Kosten