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Novel case of Parkinson’s disease and schizophrenia: challenges in the management
  1. Amna Ramzan1,
  2. Ruchi Aggarwal2 and
  3. Fariha Jamal1
  1. 1Department of Neurology, Michael E. DeBakey VA Medical Center, Baylor College of Medicine, Houston, Texas, USA
  2. 2Department of Psychiatry, Michael E. DeBakey VA Medical Center, Baylor College of Medicine, Houston, Texas, USA
  1. Correspondence to Dr Fariha Jamal; fariha.jamal{at}bcm.edu

Abstract

Coexistence of idiopathic Parkinson’s disease (iPD) and schizophrenia can pose great diagnostic and therapeutic challenges because of their pathophysiology. Our case highlights such challenges in management. We present a case of 73-year-old man who had parkinsonism for last several years and was also diagnosed with schizophrenia. Due to lack of collateral information about the onset of symptoms and clinical course, it was difficult to distinguish iPD from neuroleptic-induced parkinsonism. Even though, certain clinical findings may help to differentiate between the two conditions, single positron emission computerized tomography/DatScan was used to confirm the diagnosis of iPD. Treatment of coexisting iPD and schizophrenia can be challenging, and a delicate pharmacologic balance must be maintained to ensure adequate symptomatic control. Current evidence suggests that clozapine is a better choice for managing psychosis in these patients due to its unique receptor profile and better safety data.

  • neurology (drugs and medicines)
  • psychiatry (drugs and medicines)

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Footnotes

  • Contributors Conception and design, acquisition of data, interpretation of data, drafting the article and revising it critically for intellectual content: AR, RA and FJ.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.