What Is Amantadine?
Amantadine is an antiviral and antidyskinetic medication used to treat Parkison’s disease, and the flu. This medication has been used since the 1960’s, and was noted to cause improved focus, impulse control, and reduced mood swings. Amantadine is used off label to treat ADHD, disruptive mood dysregulation disorder (DMDD), and behavioral reactivity in autism. Amantadine is considered off label because drug companies have not conducted large trials to prove it’s effectiveness in treating these disorders, likely because they have no financial incentive to do so.
How Does Amantadine Work?
Amantadine inhibits NMDA receptors. N-methyl-D-aspartate (NMDA) receptors are involved in what’s called neuronal excitability. These receptors receive glutamate, which is the primary excitatory neurotransmitter in the brain. Excitatory doesn’t just mean it helps us feel excited; excitatory means it stimulates an electrical signal in the brain. We need these electrical signals to learn, recall memories, and have motor control. When we have too much excitability, however, it can look like irritability, aggression, and mood swings.
Amantadine blocks the NMDA receptors, meaning they can’t receive as much glutamate, which is turns decreases neuronal excitability. It also increases dopamine levels in the brain, which improves mood, coordination, and the ability to learn.
Amantadine and ADHD
Amantadine is started at a low dose of 25mg/day and gradually increased every 4-7 days. On average, people with ADHD take between 100 and 200mg every day, and the maximum dose 400mg per day. This medication comes in both a syrup and capsules and is taken every day, typically in the morning.
Amantadine and DMDD
Amantadine can help children with disruptive mood have fewer mood swings and violent outbursts. By reducing the brain’s excitability, it gives kids with DMDD more ability to control their behavior and learn coping skills for frustration.
Amantadine and Autism
It is used alone, or in combination with Trileptal to help treat irritability, aggression, and mood swings in children with autism.
Who Should NOT Use Amantadine?
We don’t use Amantadine in clients with kidney disease or glaucoma. It also shouldn’t be taken at the same time a client is receiving a live attenuated vaccine, like MMR, or chickenpox vaccines.
Matthew’s Protocol
The combination of Amantadine and Trileptal is often referred to as Matthew’s protocol, named after Dr. Daniel Matthews, the physician who developed the treatment. The combination of Amantadine and Trileptal, which is a mood stabilizer, was found to significantly improve the mood and ager outbursts of children with DMDD. The goal of Matthew’s combination is not to create totally compliant children – it’s to help the child manage their emotions so they can learn distress tolerance and coping skills for frustration. Matthew’s Protocol was originally used for kids with DMDD, but it’s now also used with children with autism who struggle with irritability and anger, including self-harm.
Is Amantadine or Matthew’s Protocol Right for My Child?
If you’re interested in discussing if these options are right for your child, and you’re in Virginia, schedule an appointment here. If you’re outside Virginia and would like parenting support/coaching, read more about available services here.