Parkinson’s disease (PD) is a neurodegenerative disorder primarily affecting the dopaminergic system, characterized by motor symptoms (tremor, rigidity, akinesia) as well as numerous psychiatric manifestations (depression, anxiety, psychosis, apathy) that significantly impair quality of life. The reported case involves a 74-year-old female patient with a 40-year history of bipolar disorder and several years of PD. The recent course was marked by a major depressive episode with psychotic symptoms. The introduction of an antipsychotic (aripiprazole) worsened the motor symptoms, while increasing L-Dopa doses intensified psychosis. A therapeutic compromise was achieved with quetiapine, which was better tolerated in terms of motor function, though less effective than clozapine. The discussion highlights the high prevalence of psychiatric disorders in PD, their impact on disease progression, and the challenge of balancing motor treatment with psychiatric symptom control. Literature supports the superior efficacy of clozapine for Parkinson’s psychosis, but also recognizes the pragmatic value of quetiapine in certain clinical contexts. Conclusion: The management of PD requires a personalized, multidisciplinary approach to reconcile the treatment of both motor and psychiatric symptoms while minimizing side effects.
Korchi et al. (Wed,) studied this question.