Amantadine and Aspiration Pneumonia
June 1, 1999
Brief Alert
Amantadine and Aspiration Pneumonia
Source: Nakagawa T, et al. Lancet 1999;353:1157.
This fascinating study from Japan assessed the frequency of pneumonia in 163 elderly stroke victims randomized to receive amantadine 100 mg daily or no intervention. Stroke victims, especially those with basal ganglia impairment, often have swallowing disorders and are at increased risk for aspiration pneumonia. Nakagawa and colleagues wondered whether amantadine, which facilitates the release of dopamine from dopaminergic nerve terminals, may improve the swallow reflex in patients with a history of cerebral infarction.
Eligible subjects were ambulatory and immunocompetent. During a follow-up period of up to three years, patients receiving amantadine were at significantly less risk for pneumonia. Only five of 83 patients (6%) receiving amantadine vs. 22 of 80 (28%) receiving no active therapy developed pneumonia (P = 0.0001). Amantadine deserves further attention in high-risk populations with selective swallowing disorders at risk for aspiration.
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