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To the Editor: Dr Bright and colleagues¹ reported an increase in adamantane-resistant influenza A viruses in the United States: less than 2% before 2002, 14.5% from October 2004 through March 2005, and 92.3% from October 1 to December 31, 2005. The authors commented that exposure to amantadine and rimantadine did not seem to explain the increased resistance, because only a minority of the samples was from nursing home settings in which the medications are most likely used. However, the viral resistance may be associated with the recent wide-scale use of another adamantane compound, memantine.

Memantine is a derivative of amantadine with 2 methyl side groups that increase its affinity and dwell time in the N-methyl-D-aspartate–sensitive glutamate receptor channel.² In late 2003, memantine was approved by the US Food and Drug Administration for the treatment of symptoms in moderate to severe Alzheimer disease. After being launched in the . . . [Full Text of this Article]

Raj C. Shah, MD
raj_c_shah@rush.edu
Department of Family Medicine
Rush University Medical Center
Chicago, Ill

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