Parkinson's disease<unk>  is used to treat Parkinson's disease-related dyskinesia and drug-induced parkinsonism syndromes.<unk>  may be used alone or in combination with another anti-Parkinson's or anticholinergic drug. The specific symptoms targeted by<unk>  therapy are dyskinesia and rigidity. The extended release<unk>  formulation is commonly used to treat dyskinesias in people receiving levodopa therapy for Parkinson's disease. A 2003 Cochrane review had concluded there was insufficient evidence to prove the safety or efficacy of<unk>  to treat dyskinesia. In 2008, the World Health Organization reported<unk>  is not effective as a stand-alone parkinsonian therapy, but recommended it could be used in combination therapy with levodopa. Influenza A<unk>  is not recommended for treatment or prophylaxis of influenza A in the United States.<unk>  has no effect preventing or treating influenza B infections. The US Centers for Disease Control and Prevention found 100% of seasonal H3N2 and 2009 pandemic flu samples were resistant to adamantanes<unk>  and rimantadine) during the 2008–2009 flu season. The U.S. Centers for Disease Control and Prevention (CDC) guidelines recommend only neuraminidase inhibitors for influenza treatment and prophylaxis. The CDC recommends against<unk>  and rimantadine to treat influenza A infections. Similarly, the 2011 World Health Organization (WHO) virology report showed all tested H1N1 influenza A viruses were resistant to<unk> . WHO guidelines recommend against use of M2 inhibitors for influenza A. The continued high rate of resistance observed in laboratory testing of influenza A has reduced the priority of M2 resistance testing. A 2014 Cochrane review did not find evidence for efficacy or safety of<unk>  used for the prevention or treatment of influenza A. Extra-pyramidal side effects An extended release formulation is used to treat levodopa-induced dyskinesia in patients with Parkinson's disease. The WHO recommends the use of<unk>  as a combination therapy to reduce levodopa side effects. Off-label uses Fatigue in multiple sclerosis<unk> , along with modafinil and methylphenidate, are the most commonly used medications for the treatment of multiple sclerosis (MS) related fatigue in clinical practice. A 2007 Cochrane literature review concluded that there was no overall evidence supporting the use of<unk>  in treating fatigue in patients with MS. A follow up 2012 Cochrane review stated that there may be some<unk> -induced improvement in fatigue in some people with MS. Despite multiple control trials that have also demonstrated improvements in subjective and objective ratings of fatigue, there is no final conclusion regarding its effectiveness. Consensus guidelines from the German Multiple Sclerosis Society (GMSS) in 2006 state that<unk>  produces moderate improvement in subjective fatigue, problem solving, memory, and concentration. Thus, GMSS guidelines strongly recommend the use of<unk>  in MS-related fatigue. Awareness in patients with disorders of consciousness Disorders of consciousness (DoC) include coma, vegetative state (VS), and minimally conscious state (MCS).<unk>  has been shown to increase the rate of emergence from a MCS, defined by consistent demonstration of interactive communication and functional objective use. In traumatic brain injury patients in the intensive care unit,<unk>  has also been shown in various randomized control trials to increase the rate of functional recovery and arousal, particularly in the time period immediately following an injury. There are also reports of significantly improved consciousness in patients treated for non-traumatic cases of DoC, such as in the case of a subarachnoid hemorrhage, cerebral hemorrhage, and hypoxic encephalopathy. In 2018 the American Academy of Neurology (AAN) updated treatment guidelines on the use of<unk>  for patients with prolonged DoC, recommending the use of<unk>  (100–200 mg bid) for adults with DoC 4–16 weeks post injury to support early functional recovery and reduce disability. Neuroplasticity and overall functional recovery in patients with brain injury In various studies,<unk>  and memantine have been shown to accelerate the rate of recovery from a brain injury. The time-limited window following a brain injury is characterized by neuroplasticity, or the capacity of neurons in the brain to adapt and compensate after injury. Thus, physiatrists will often start patients on<unk>  as soon as impairments are recognized. There are also case reports showing improved functional recovery with<unk>  treatment occurring years after the initial brain injury. There is insufficient evidence to determine if the functional gains are a result of effects through the dopamine or norepinephrine pathways. Some patients may benefit from direct dopamine stimulation with<unk> , while others may benefit more from other stimulants that act more on the norepinephrine pathway, such as methylphenidate. It is unclear if treatment with<unk>  improves long-term outcomes or simply accelerates recovery. Nonetheless,<unk> -induced acceleration of recovery reduces the burden of disability, lessens health care costs, and minimizes psychosocial stressors in patients.
Amantadine
Rimantadine
Quifenadine
Alcaftadine
Umifenovir
Tecovirimat
Rupatadine
Inadine