OBJECTIVES: Five decades after introduction, levodopa remains the treatment of choice for PD. Chronic levodopa treatment with progressing PD contributes to levodopa-induced dyskinesia (LID), defined as involuntary, non-rhythmic, purposeless, unpredictable movements during waking hours occurring in approximately 30% of patients. LID can compromise optimal levodopa treatment. No FDA-approved drug for LID exists. AMT-IR was originally approved for influenza and later indicated in parkinsonism. It has also been evaluated in small studies for the treatment of dyskinesia. Conflicting guidelines for the use of AMT-IR in dyskinesia exist. While higher doses of AMT-IR have been shown to produce greater reductions in dyskinesia, they are associated with increased frequency of central nervous system adverse events. Real-world use, persistence, and adherence for AMT-IR has not been extensively analyzed or reported. METHODS: A retrospective claims-based analysis was conducted utilizing Symphony Health data to evaluate current AMT-IR utilization patterns in PD patients persistent on levodopa for at least 4 years (indicating presence of LID (Suh, 2012). Persistence was defined as continuous therapy without refill gaps > 90 days. Adherence was defined as ≤ 5 days between expected and actual refill dates. RESULTS: Among 22,000 patients persistent on levodopa for 4 years, approximately 1,500 (6.8%) had taken AMT-IR. At 1 year, 39% were persistent and 7% were adherent. The average starting dose was approximately 200 mg/day amantadine HCl (equivalent to 162 mg amantadine). Only 15% of patients started at 300mg/day amantadine HCl (equivalent to 243 mg amantadine) or greater. At one year, among those initiated on ≥300mg/day (243 mg amantadine), 38% were persistent while only 4% were adherent. CONCLUSIONS: This claims analysis demonstrates limited persistence and adherence at daily doses of 200-300 mg AMT-IR in PD patients. Higher dosage forms and improved delivery systems for amantadine in the treatment of LID may increase efficacy, persistence, and adherence.