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Amantadine + levodopa + carbidopa is a combination therapy being investigated by Weill Medical College of Cornell University for the treatment of disorders of consciousness (DOC) resulting from severe traumatic brain injury (TBI). This pharmacological challenge aims to address the downregulation of the anterior forebrain mesocircuit, a key mechanism in DOC, by modulating synaptic background activity. Amantadine acts as an N-methyl-D-aspartate (NMDA) receptor antagonist and promotes dopamine release, while levodopa serves as a metabolic precursor to dopamine, and carbidopa prevents its peripheral degradation by inhibiting aromatic-L-amino-acid decarboxylase. By increasing dopamine availability and regulating glutamatergic homeostasis, the combination is intended to restore synaptic activity and improve arousal and goal-directed behavior in post-traumatic patients.
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