Parkinsonism is seen frequently in patients with psychiatric conditions. Drug-induced parkinsonism (DIP) is the second most common cause of parkinsonism in the general population after Parkinson’s disease (PD) but a range of rarer aetiologies, some of them reversible, should also be considered in patients of all ages. DIP is more common in older patients, as are neurodegenerative diseases that may produce parkinsonism and it is relatively more likely that drug exposure could be unmasking an underlying process in this population. There is an extensive literature on differentiating DIP from PD but clinical features can be indistinguishable and many proposed investigations are not readily available. Aside from cessation of the responsible medication, there is no clear consensus on treatment strategies or duration of treatment. Practically, a delicate balance must be achieved between ameliorating parkinsonism and avoiding recurrent psychosis. Long-term prognosis in the setting of DIP remains unclear. We review the features that may differentiate DIP from other causes of parkinsonism in patients with psychiatric illness, provide an update on relevant investigations and discuss management strategies. The use of atypical antipsychotics for a broad range of indications highlights the ongoing relevance of DIP.

中文翻译：

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精神病学中的帕金森病：临床分化和治疗的最新进展

患有精神病的患者经常出现帕金森病。药物诱发的帕金森病（DIP）是仅次于帕金森氏病（PD）的普通人群中第二大最常见的帕金森病病因，但对于所有年龄段的患者，也应考虑一系列罕见病因，其中一些是可逆的。DIP在老年患者中更常见，神经退行性疾病可能会产生帕金森氏症，而药物暴露可能更可能掩盖该人群的潜在病程。关于将DIP与PD区别开来已有大量文献，但临床特征可能难以区分，许多提议的研究还不容易获得。除了停止使用负责任的药物外，在治疗策略或治疗持续时间方面尚无明确共识。几乎，在缓解帕金森症和避免精神病复发之间必须达到微妙的平衡。DIP的长期预后尚不清楚。我们回顾了可将DIP与精神病患者帕金森病其他原因区分开的功能，提供了有关调查的最新信息并讨论了管理策略。非典型抗精神病药在广泛的适应症中的应用突显了DIP的持续相关性。