
Parkinsonism is a clinical syndrome characterised by tremor, bradykinesia, rigidity and postural instability. While commonly associated with idiopathic Parkinson’s disease, drug-induced Parkinsonism is a notable adverse effect of certain medications, including antipsychotics like risperidone and antiepileptic drugs like valproic acid. The case report focuses on a 59-year-old female with schizophrenia and bipolar disorder who developed drug-induced parkinsonism after being treated with risperidone (4 mg/day) and valproic acid (290 mg/day). The patient presented with tremors, rigidity, bradykinesia, and a shuffling gait, symptoms resembling those of Parkinson's disease. A thorough evaluation confirmed the onset of parkinsonism, likely resulting from the synergistic interaction between the two medications. Risperidone is a second-generation antipsychotic used in the treatment of Schizophrenia, Bipolar Disorder, and irritability in autism disorder. Valproic acid is an antiepileptic drug used in the management of seizure and as a mood stabiliser. Risperidone, a dopamine D2 receptor antagonist, can reduce dopaminergic activity in the brain, leading to motor dysfunction. Valproic acid, while primarily used as an anticonvulsant and mood stabilizer, has been associated with an increased risk of extrapyramidal side effects. Concurrent use of these drugs may synergistically increase the risk of Parkinsonism, especially in elderly patients or those with comorbidities by altering the dopamine metabolism. After discontinuation of risperidone, the patient's symptoms improved significantly, with partial resolution of motor signs. However, mild residual tremor persisted, likely due to the lasting effects of valproic acid.
Risperidone, Valproic acid, Parkinsonism, Drug-induced extrapyramidal symptoms, Dopaminergic dysfunction
Risperidone, Valproic acid, Parkinsonism, Drug-induced extrapyramidal symptoms, Dopaminergic dysfunction
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