Reactions 2001, p213 - 30 Mar 2024 1

Multiple drugs S

Drug-induced parkinsonism
A 56-year-old man developed drug-induced parkinsonism during treatment with chlorpromazine, risperidone, sodium valproate
and trihexyphenidyl for psychiatric illness [not all dosages stated; routes and duration of treatments to reaction onset not stated].
The man was hospitalised due to generalised weakness, inability to walk for 15 days, and abnormal movements of the upper and
lower limbs for a month. His medical history included a generalised tonic-clonic seizure. He had been receiving chlorpromazine
100mg tablet, risperidone 2mg tablet, trihexyphenidyl 2mg tablet and sodium valproate 500mg twice daily for psychiatric illness.
During the current presentation, he reported experiencing mild tremors. Clinical examination showed resting tremors, bilateral
cogwheel rigidity and head titubation. Additionally, concurrent age-related cerebral atrophy, hypertensive leukoencephalopathy and
chronic bilateral corona radiata infarcts were noted. He also exhibited symptoms of psychiatric illness, including suspiciousness,
irritability, and verbal and physical aggression. He had no history of substance abuse, withdrawal symptoms, or any other illness. He
was referred to the psychiatry department, where a diagnosis of drug-induced parkinsonism secondary to chronic use of
chlorpromazine, risperidone, sodium valproate and trihexyphenidyl was made.
Subsequently, chlorpromazine and sodium valproate were discontinued, while the man continued risperidone and
trihexyphenidyl therapy. He started receiving treatment with levodopa and clonazepam, leading to symptomatic improvement.
After 11 days, he was discharged on levodopa, clonazepam, aspirin, atorvastatin, risperidone and trihexyphenidyl, with a schedule
for follow-ups.
Rao A, et al. Chronic Neuroleptic Therapy and Progressive Parkinsonism: A Case Report. Journal of Young Pharmacists 16: 137-138, No. 1, Mar 2024. Available from: URL:
https://dx.doi.org/10.5530/jyp.2024.16.19 803849511