Olanzapine and clozapine: Comparative effects on motor function in hallucinating PD patients
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To the Editor:
We read with interest the reports of Goetz et al.1 and Manson et al.2 One of our recent patients is illustrative of the combined reported findings. This 76-year-old man had a 11-year history of idiopathic PD. After 7 years of taking one and a half tablets of levodopa/carbidopa 100/25 mg six times a day and bromocriptine 10 mg three times daily, he developed hallucinations, illusions, and occasional delusions. Discontinuation of bromocriptine did not provide significant relief, and he was treated successfully with olanzapine 5 mg daily, without any noticeable worsening of motor function. Four years later, while taking levodopa/carbidopa 100/25 mg, two tablets seven times a day, his psychiatric status worsened; hallucinations recurred this time with poor insight and some delusional beliefs related to the nurses in his nursing home. There was no clear correlation with any recent medication changes. Olanzapine was then switched to clozapine 12.5 mg daily. After a month, his hallucinations and delusions completely remitted. However, his dyskinesias increased …
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