The efficacy of amantadine in the symptomatic treatment of patients with Parkinson's disease, discovered serendipitously more than 50 years ago, has stood the test of time and the drug is still commonly used by neurologists today. Its pharmacological actions are unique in combining dopaminergic and glutamatergic properties, which account for its dual effect on parkinsonian signs and symptoms and levodopa-induced dyskinesias. Furthermore, amantadine has additional and less well-defined pharmacological effects, including on anticholinergic and serotonergic activity. Evidence from randomised controlled trials over the past 5 years has confirmed the efficacy of amantadine to treat levodopa-induced dyskinesias in patients with Parkinson's disease, and clinical studies have also provided support for its potential to reduce motor fluctuations. Other uses of amantadine, such as in the treatment of drug-induced parkinsonism, atypical parkinsonism, Huntington's disease, or tardive dyskinesia, lack a strong evidence base. Future trials should examine its role in the management of motor and non-motor symptoms in patients with early Parkinson's disease and those with other movement disorders.

50 多年前偶然发现的金刚烷胺在帕金森病患者对症治疗中的功效经受住了时间的考验，该药至今仍为神经科医生常用。它的药理作用在结合多巴胺能和谷氨酸能特性方面是独一无二的，这说明了它对帕金森症状和左旋多巴引起的运动障碍的双重作用。此外，金刚烷胺具有额外的和不太明确的药理作用，包括抗胆碱能和 5-羟色胺能活性。过去 5 年的随机对照试验证据证实了金刚烷胺治疗左旋多巴引起的帕金森病患者运动障碍的疗效，临床研究也为其减少运动波动的潜力提供了支持。金刚烷胺的其他用途，例如治疗药物性帕金森病、非典型帕金森病、亨廷顿病或迟发性运动障碍，缺乏强有力的证据基础。未来的试验应检查其在早期帕金森病患者和其他运动障碍患者运动和非运动症状管理中的作用。