Amantadine

Adamantane (antiviral; glutamate NMDA antagonist, increases norephinephrine, higher doses increases dopamine)

Dosing

100-300mg daily in divided doses, morning and afternoon. Raise by 100mg/wk

Management

Caution in heart disease (edema in CHF). Warn patient that 1 in 10 people don’t tolerate it for various reasons, headache, dizzy, even hallucinations rarely (it is dopaminergic). It also has ketamine like effects and we’ve seen some severe depressions spontaneously recover on it along with intense spiritual feelings (advice patient with depression to engage more in something that inspires awe, beauty, spirituality, while taking the med, as we do with ketamine).

EMR Text