benztropine 2 mg t.i.d., and she was dis- charged from inpatient treatment on this dosage.She began attending a psychiatric re- habilitation day hospital shortly afterwards, and one month after starting pimozide 4 mg b.d.her schizophrenic symptomatology ap- peared to be under con rol, but she was complaining of poor visual acuity.On examination there was paralysis of the ciliary muscle of both eyes, with fixed dilated pupils, and paralysis of accommodation.She was examined by an ophthalmologist at this time and no other abnormality noticed to account for this.Pimozide was reduced to 2 mg daily as a maintenance dose, and orphenadrine 50 mg t.i.d.substituted for benztropine.Her vision and pupillary re- sponses to light and accommodation gradually returned to normal over the following two weeks.It would appear, therefore, that as well as causing Parkinsonian side effects in a dosage of 8 mg daily, pimozide caused paralysis of accommodation, and interfered with normal pupillary reactions.
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R. Edgar Hope-Simpson (1971) studied this question.