Pharmacotherapy in Psychiatry and Neurology
eISSN: 2449-9315
ISSN: 1234-8279
Pharmacotherapy in Psychiatry and Neurology/Farmakoterapia w Psychiatrii i Neurologii
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1/2025
vol. 41
 
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abstract:
Case report

Amantadine-induced psychosis in a patient with chronic renal failure – a case report

Rafał Bieś
1
,
Maciej Niczewski
2
,
Ewa Martyniak
3
,
Jan Duława
2
,
Marek Krzystanek
3

  1. Doctoral School, Department and Clinic of Psychiatric Rehabilitation, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Katowice, Poland
  2. Department of Internal Medicine and Metabolic Diseases, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
  3. Clinic of Psychiatric Rehabilitation, Department of Psychiatry and Psychotherapy, Medical University of Silesia in Katowice, Katowice, Poland
Farmakoterapia w Psychiatrii i Neurologii 2025, 41 (1), 49-55
DOI: https://doi.org/10.5114/fpn.2025.154613
Online publish date: 2025/10/30
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Objectives
Amantadine has a broad spectrum of action, including dopamine agonism in the central nervous system. Owing to its stimulation of dopaminergic pathways, the drug may induce psychiatric side effects, most commonly visual hallucinations.

Case report
We report the case of a 68-year-old woman admitted to hospital with abdominal pain, an exacerbation of chronic renal failure, and worsening cardiorespiratory function. During her hospital stay, the patient was administered amantadine, the elimination of which was impaired due to renal insufficiency and anuria, necessitating haemodialysis. The elevated blood concentration of amantadine resulted in a psychotic state, which resolved completely following drug withdrawal and treatment with haloperidol.

Conclusions
Psychosis is a recognised side effect of long-term amantadine use in Parkinson’s disease. This case is notable for the rapid onset of psychotic symptoms in a patient with no prior history of neurological or psychiatric disorders. This report underscores the potential risks associated with amantadine use in patients with impaired renal function.

keywords:

psychosis, renal failure, hallucinations, amantadine

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