Amantadine and COVID-19 - is it a new drug for the SARS-CoV-2 coronavirus?

Amantadine is a drug that has been used for several decades and is effective primarily in relieving the symptoms of Parkinson's disease. Its beneficial properties in treating people infected with influenza A have also been proven. However, the potential effects of amantadine on the SARS-CoV-2 coronavirus are the most exciting.

What is amantadine?

Amantadine is a drug invented in 1964 by duPont. It was originally used in neurology and psychiatry to treat movement disorders and to control the side effects of neuroleptics (antipsychotics). In 1976, amantadine was approved by the FDA for the treatment of people infected with influenza A.

The mechanism of action of amantadine

The mechanism of action of amantadine is multidirectional:

• Parkinson's disease: NMDA glutamate receptor antagonist. Blocking these receptors allows you to alleviate the so-called Parkinsonian symptoms: muscle twitching and / or stiffness, changes in body posture, slow movements.
• Influenza A: blocking the proton pump of the viral protein M2, which stops the removal of the envelope of the virus and inactivates its haemagglutinin. These processes indirectly lead to inhibition of virus replication.
• COVID-19: a potential mechanism of action is permeation through the membrane of the viral lysosome. The alkalising effect of amantadine prevents the release of viral RNA into the cell.

Amantadine - side effects

Among the most common side effects, the manufacturer lists neurological and psychiatric symptoms:

• bow,
• mood changes
• insomnia,
• Headache,
• blurred vision,
• lack of concentration,
• slurred speech,
• palpitations,
• muscle aches.

Overdosage with amantadine can be fatal. The lowest documented lethal dose was 2 g.

Amantadine - contraindications

The drug is contraindicated during pregnancy, in women planning pregnancy and during breastfeeding.

Amantadine and COVID-19

Amantadine in Poland was promoted in October last year by a pediatrician and pulmonologist from Przemyśl - Włodzimierz Bodnar. He claimed to have over 100 documented cures in COVID-19 patients with amantadine given in the appropriate regimen. According to the doctor, the preparation stabilizes the vast majority of cases and causes the symptoms of infection to disappear after 48 hours. Since then, amantadine has become, in the public opinion, a "miracle drug", but with clinically undocumented effects on the SARS CoV-2 coronavirus - both in Poland and in the world. However, social pressure on the use of this drug in COVID-19 led to the fact that in January, at the request of the Minister of Health, Adam Niedzielski, the Medical Research Agency decided to conduct clinical trials. For this purpose, the "double-blind" method will be used - a situation where neither the doctor nor the patient knows whether a drug or a placebo is being administered. This is the most reliable type of test that excludes the effects of subjective feelings after using the preparation.

About 200 volunteers over the age of 18 will be tested.

Seven centers are involved in clinical trials of amantadine:

• Independent Public Clinical Hospital No. 4 in Lublin,
• Central Clinical Hospital of the Ministry of Interior and Administration in Warsaw,
• University Clinical Center of the Medical University of Warsaw,
• Clinical Provincial Hospital No. St. Queen Jadwiga in Rzeszów,
• Regional Specialist Hospital for them. dr. Władysław Biegański,
• Independent Public Healthcare Center in Grudziądz,
• Independent Public Complex of Healthcare Institutions in Wyszków.

According to a neurologist from the Medical University of Lublin, prof. Konrad Rejdak, preliminary research results indicate the possible effectiveness of amantadine administered at the beginning of the infection, immediately after a positive PCR test result, but before the development of full symptoms of the disease, including neurological symptoms. The doctor says full reliable test results will be available in late May. Meanwhile, as of June 7, the results of research on amantadine have not been made publicly available.

It should be remembered that no drug is without its effect on the body, and if not used properly, it can pose a greater risk than the infection itself. Used for several decades, amantadine is a well-known drug, both in terms of long-term effects and in terms of its side effects. The results of clinical trials will provide scientific evidence for the value of amantadine in treating COVID-19.