Risperidone
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Parkinsonism: case report A 43-year-old woman developed parkinsonism during treatment with risperidone for psychotic disorder. The woman presented to the psychiatric department at the age of 39 years due to occurrence of psychotic symptoms after treatment of seizure for 25 years. After investigation, she was diagnosed with psychotic disorder due to epilepsy. Her medical history included epilepsy, diabetes, cleft palate, hypocalcaemia and mild intellectual disability. She also had non-febrile seizure. She had undergone a cleft palate surgery at the age of 7 years and had a language disturbance since then. She also had history of frequent colds possibly due to immune dysfunction. She had experienced tonic-clonic type of seizure at the age of 14 years despite treatment with unspecified antiepileptics. Due to irregular medications, she had developed psychotic symptoms and presented to the psychiatric department at the age of 39 years, and diagnosed with psychotic disorder due to epilepsy. She was treated with antipsychotics that led to an improvement in her symptoms. However, she was noncompliant to the treatment that led to deterioration of her psychotic symptoms, and she was admitted to the hospital at the age of 41 years. Thereafter, her clinical course was different. She had aggravation of psychotic symptoms without seizure and sometimes improvement without antipsychotics. She was started on risperidone 4 mg/day [route not stated] for her psychotic disorder. She received risperidone for 2 years regularly and consistently. However, at the age of 43 years, she developed parkinsonism described as rigidity and tremor [duration of treatment to reaction onset not stated]. Subsequently, her symptoms aggravated rapidly; hence, she was again admitted to the hospital. It was considered that the parkinsonism related to risperidone. The woman was treated with benzatropine [benztropine], diazepam and propranolol and risperidone was tapered. Eventually, her psudoparkinsonism resolved. Therefore, she was transferred to an outpatient clinic without antipsychotic therapy and without recurrence of psychotic symptoms for a year. However, she had recurrence of auditory hallucination and persecutory delusion at the age of 44 years and she was admitted the third time. Subsequently, bipolar disorder with psychotic features was suspected due to course fluctuation and prominent mood symptoms. Additionally, schizophrenia was also suspected. She underwent brain CT scan that showed bilateral basal ganglia calcifications; hence, possibility of other medical problems except epilepsy were concluded. Therefore, she underwent a FISH test that revealed DiGeorge syndrome. Kim G, et al. Various psychiatric manifestation in digeorge syndrome (22q11.2 deletion syndrome): A case report. Clinical Psychopharmacology and Neuroscience 18: 803504681 458-462, No. 3, Aug 2020. Available from: URL: http://doi.org/10.9758/CPN.2020.18.3.458
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