The commonest cause for drug induced Parkinsonism is neuroleptic. When most of the drugs come in this category can cause some amount of Parkinsonism. When you compare the conventional neuroleptics and compare it to the newer generation neuroleptics, the incidence or the severity may be less, but this will also cause Parkinsonism. But there are also Parkinson’s disease, patients have hallucination and psychosis. We prefer usually the atypical antipsychotics like cloazpine, quetiapine in this type of situations. So the newer type of drugs like cloazpine, quetiapine cause less worsening of the Parkinson’s, who have already existing Parkinson’s disease or who are used for primarily psychotic disorders. They are less likely to cause Parkinsonism we need to keep a close watch on these patients to optimise the dose of the medications or switch on from one set of antipsychotics to other set of antipsychotic. Mostly the Parkinsonism can be reversible, but there can be some amount of residual slowness even after stopping these medications. So entirely it may not be reversible and also depends on the continuation of the primary drug. So you need to continue the medications, the neuroleptics for longer duration. So you have to balance that and use appropriate dosing and class of drugs to minimise the Parkinsonism, whereas when you compare levosulpiride induced Parkinsonism or valproate induced Parkinsonism, the condition can be entirely reversed. So you need to have high index of suspicion when you come across recent onset of Parkinsonism and you can identify the drugs, you can definitely identify how to reverse the condition entirely.

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