Drug-induced parkinsonism: A case report

Area of Science:

• Neuroscience
• Psychiatry
• Pharmacology

Background:

• Drug-induced parkinsonism (DIP) is a condition mimicking idiopathic Parkinson's disease, triggered by specific medications.
• Antipsychotic medications, particularly dopamine receptor antagonists, are known culprits for inducing parkinsonian symptoms.
• Early identification and management of DIP are crucial to prevent irreversible neurological damage.

Purpose of the Study:

• To report a case of severe parkinsonism potentially induced by paliperidone long-acting injection (LAI) in a patient with a history of bipolar disorder.
• To emphasize the need for clinical vigilance regarding the neurotoxic potential of long-acting antipsychotics.

Main Methods:

• A case study of a 68-year-old male patient with bipolar disorder treated with multiple psychotropic medications, including paliperidone LAI.
• Detailed clinical observation of symptom progression, medication changes, and diagnostic assessment for drug-induced parkinsonism.

Main Results:

• The patient developed parkinsonian symptoms, cognitive decline, and functional impairment following administration of paliperidone LAI.
• Despite discontinuation of neuroleptics, the patient experienced a complicated hospital course and ultimately died approximately 5 months after paliperidone LAI initiation.
• A temporal relationship suggests paliperidone LAI as a likely contributing factor to the severe parkinsonism.

Conclusions:

• Paliperidone LAI may be associated with the development of severe drug-induced parkinsonism, even in patients with pre-existing psychiatric conditions.
• Clinicians must be aware of the potential long-term neurological risks associated with long-acting injectable antipsychotics.
• Further research is warranted to elucidate the precise mechanisms and risk factors for antipsychotic-induced parkinsonism.