Lesson of the Week: Cystic fibrosis presenting as hyponatraemic heat exhaustion

relation to psychiatric side effects, should then be progressively tapered.If the patient is still psychotic thioridazine or sulpiride should be given, but these will often cause unacceptable worsening of parkinsonism.In many countries clozapine is then the drug of choice,'0 but in Britain it is licensed for use only in treatnent resistant schizophrenia.In the acutely, severely disturbed patient antipsychotic treatment may have to be started immediately, sometimes even using more incisive conventional neuroleptics. ConclusionsThe drug treatment of Parkinson's disease is chal- lenging but highly rewarding.The choice, dose, and timing of several different drugs need to be indi- vidually tailored, ideally on the basis of accurate feedback concerning fluctuations, dyskinesia, and other side effects.The broad recommendations presented above are intended as a guide.They should not be followed too rigidly and will probably change in the light offurther evidence from clinical trials.