Clinical characteristics of neuroleptic induced parkinsonism

Background: Neuroleptic treatment may cause short-term Parkinsonian symptoms, whose relations to Parkinson's disease (PD) is controversial. Objective: To characterize the clinical spectrum of neuroleptic induced Parkinsonism (NIP). Methods: The study population was composed of psychiatric patients treated with neuroleptics, diagnosed by the primary psychiatrist as having Parkinsonism. Neurological assessment was done by a movement disorders specialist performing the full Unified Parkinson's Disease Rating Scale (UPDRS) exam, after anticholinergic drugs were stopped for at least 48 hours. For analysis only patients who had at least two or three cardinal symptoms: rest tremor, rigidity or bradykinesia, were included. Results: A total of 39 patients, with an average age of 40 years and a mean duration of neuroleptic therapy of 9.9 years, were examined and their clinical features are described. Conclusions: NIP was found to be commonly asymmetric with upper rather than lower body involvement, and its severity correlated positively with the duration of neuroleptic treatment.