Department of Neurology, St. Joseph Hospital Berlin-Weissensee, Gartenstr. 1, 13088, Berlin, Germany.
Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Füchsleinstrasse 15, 97080, Würzburg, Germany.
Expert Rev Clin Pharmacol. 2023 Feb;16(2):101-107. doi: 10.1080/17512433.2023.2176301. Epub 2023 Feb 8.
The aminoadamantanes amantadine and memantine are well known. They mainly act as N-methyl-D-aspartate antagonists.
The antiviral drug amantadine moderately ameliorates impaired motor behavior in patients with Parkinson's disease. Memantine provides beneficial effects on memory function in patients with advanced Alzheimer's disease already treated with acetylcholine esterase inhibitors. Both compounds counteract impaired monoamine neurotransmission with associated symptoms, such as depression. They improve vigilance, lack of attention and concentration, fatigue syndromes according to clinical findings in patients with chronic neurodegenerative processes. Their extrasynaptic N-methyl-D-Aspartate receptor blockade weakens a prolonged influx of Ca ions as the main responsible components of neuronal excitotoxicity. This causes neuronal dying and associated functional deficits.
We suggest aminoadamantanes as future therapies for amelioration of short- and long-term consequences of a COVID 19 infection. Particularly the extended-release amantadine formulations will be suitable. They showed better clinical efficacy compared with the conventional available compounds. Amantadine may particularly be suitable for amelioration of fatigue or chronic exhaustion, memantine for improvement of cognitive deficits. Clinical research in patients, who are affected by the short- and long-term consequences of a COVID 19 infection, is warranted to confirm these still hypothetical putative beneficial effects of aminoadamantanes.
氨基烷烃金刚烷胺和盐酸美金刚是众所周知的。它们主要作为 N-甲基-D-天冬氨酸拮抗剂发挥作用。
抗病毒药物金刚烷胺可适度改善帕金森病患者受损的运动行为。盐酸美金刚可改善已接受乙酰胆碱酯酶抑制剂治疗的晚期阿尔茨海默病患者的记忆功能。这两种化合物都可以通过改善与抑郁等相关症状的单胺神经递质传递来发挥作用。它们根据慢性神经退行性过程患者的临床发现，改善警觉性、注意力不集中和疲劳综合征。它们通过抑制突触外 N-甲基-D-天冬氨酸受体，减弱 Ca 离子的过度流入，而 Ca 离子是神经元兴奋性毒性的主要组成部分。这会导致神经元死亡和相关的功能缺陷。
我们建议将氨基烷烃类药物作为改善 COVID-19 感染短期和长期后果的未来疗法。特别是延长释放金刚烷胺制剂将是合适的。与传统的可用化合物相比，它们显示出更好的临床疗效。金刚烷胺可能特别适合改善疲劳或慢性疲劳，盐酸美金刚可改善认知缺陷。有必要对受 COVID-19 感染短期和长期后果影响的患者进行临床研究，以证实这些仍处于假设阶段的氨基烷烃类药物的潜在有益作用。
