[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-433122-105":59,"doc-detail-433122-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","previously-incarcerated-veteran-a-case-of-drug-induced-parkinsonism","Previously Incarcerated Veteran - A Case of Drug-Induced Parkinsonism","","Drug-induced Parkinsonism (DIP) is a recognized extrapyramidal side effect of prolonged antipsychotic therapy, usually emerging early after antipsychotic initiation. This report describes a rare late-onset case in a 64-year-old previously incarcerated male veteran with schizophrenia who had taken risperidone for nearly 40 years without regular psychiatric follow-up. He developed one month of progressive rigidity, dysarthria, and dysphagia, with exam findings consistent with DIP. Management included gradual risperidone tapering, benztropine for symptom control, and aripiprazole to sustain psychiatric stability, with marked improvement, underscoring the need for ongoing medication review and follow-up.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/previously-incarcerated-veteran-a-case-of-drug-induced-parkinsonism/433122/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/previously-incarcerated-veteran-a-case-of-drug-induced-parkinsonism/433122.png","ImageObject",300,407,{"name":92,"@type":93},"jay","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why is drug-induced Parkinsonism (DIP) considered an extrapyramidal side effect of antipsychotics?","Question",{"text":112,"@type":113},"DIP is described as an EPS linked to prolonged antipsychotic therapy. It is typically related to dopamine D2 receptor blockade affecting motor control pathways.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What clinical features in the case supported a diagnosis of DIP?",{"text":117,"@type":113},"Neurological evaluation showed cogwheel rigidity, slow speech, flat affect, and dysdiadochokinesia. The presentation was consistent with DIP rather than idiopathic Parkinson’s disease.",{"name":119,"@type":110,"acceptedAnswer":120},"How was the patient treated and what was the outcome?",{"text":121,"@type":113},"Treatment involved gradual tapering of risperidone, benztropine for symptomatic relief, and initiation of aripiprazole to maintain psychiatric stability. Symptoms markedly improved after these changes.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},433122,1790716812,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":29,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},3985747858866,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","Received 08/13/2025  \nReview began 09/19/2025  \nReview ended 11/29/2025  \nPublished 12/05/2025  \n© Copyright 2025  \nBailey et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.98525  \nOpen Access Case Report  \nPublished via Dr. Kiran C. Patel College of Osteopathic Medicine (KPCOM)  \nPreviously Incarcerated Veteran: A Case of DrugInduced Parkinsonism  \nBrian R. Bailey 1 , Ashley Mason 2, Vien Dinh 3  \n1. Emergency Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA 2. Neurology, University of South Florida Morsani College of Medicine, Tampa, USA 3. Psychiatry, Veterans Affairs Medical Center, St. Petersburg, USA  \nCorresponding author: Vien Dinh, [vien.dinh@va.gov](vien.dinh@va.gov)  \nAbstract  \nDrug-induced Parkinsonism (DIP) is a recognized extrapyramidal side effect (EPS) associated with prolonged antipsychotic therapy, and typically occurs early in antipsychotic initiation. We present a rare case of lateonset DIP in a 64-year-old previously incarcerated male veteran with schizophrenia, who had been maintained on risperidone for nearly 40 years without regular psychiatric follow-up. The patient presented with a one-month progression of rigidity, dysarthria, and dysphagia. Upon admission, neurological evaluation revealed significant cogwheel rigidity, slow speech, flat affect, and dysdiadochokinesia consistent with DIP. Treatment involved gradual tapering of risperidone, introduction of benztropine for symptomatic relief, and initiation of aripiprazole to maintain psychiatric stability. Symptoms markedly improved, reaffirming the diagnosis of DIP over idiopathic Parkinson 's disease. This case emphasizes the importance of regular medication review and follow-up in managing antipsychotic therapy to prevent severe EPS complications, particularly in vulnerable populations such as incarcerated individuals and military veterans.  \nCategories: Psychiatry, Pharmacology  \nKeywords: aripiprazole, benztropine, drug-induced parkinsonism, extrapyramidal symptoms, incarceration, risperidone, schizophrenia, second-generation antipsychotics, veterans  \nIntroduction  \nThe use of antipsychotic medications for the treatment of schizophrenia is well-established ; secondgeneration antipsychotics (SGAs) are preferred as they improve both positive and negative symptoms with a reduced side-effect profile compared with first-generation antipsychotics [1,2] . Antipsychotics exert their effects through dopamine D2 receptor blockade in the brain 's nigrostriatal pathway, which regulates motor control ; second-generation antipsychotics (SGAs) bind these receptors with lower affinity than firstgeneration agents, thereby reducing but not eliminating the risk of D2 receptor-related side effects [1-5].  \nThis risk of movement-associated side effects, called extrapyramidal side effects (EPS), also rises in patients taking multiple antipsychotics simultaneously [2,6] . EPS includes dystonias, tardive dyskinesia, and, importantly, Parkinsonism [4,7,8].  \nParkinson 's disease (PD) itself is a progressive neurodegenerative disorder characterized by the loss of dopaminergic neurons in the substantia nigra pars compacta and the accumulation of misfolded α-synuclein aggregates (Lewy bodies and neurites) that disrupt neuronal and synaptic function [9, 10] . The pathogenesis involves mitochondrial dysfunction, lysosomal impairment, neuroinflammation, and aberrant protein aggregation, with genetic mutations in SNCA, LRRK2, PINK1, and Parkin providing mechanistic insight into both familial and sporadic disease [10]. Experimental models have been critical to discovering these mechanisms: neurotoxin-based animal models (e.g., MPTP, 6-OHDA, rotenone) and pharmacologic models (e.g., haloperidol-","cbCaipdDkvX5qOHh","https://ap.wps.com/l/cbCaipdDkvX5qOHh","pdf",164457,"English","# Abstract\n# Introduction","[{\"question\":\"Why is drug-induced Parkinsonism (DIP) considered an extrapyramidal side effect of antipsychotics?\",\"answer\":\"DIP is described as an EPS linked to prolonged antipsychotic therapy. It is typically related to dopamine D2 receptor blockade affecting motor control pathways.\"},{\"question\":\"What clinical features in the case supported a diagnosis of DIP?\",\"answer\":\"Neurological evaluation showed cogwheel rigidity, slow speech, flat affect, and dysdiadochokinesia. The presentation was consistent with DIP rather than idiopathic Parkinson’s disease.\"},{\"question\":\"How was the patient treated and what was the outcome?\",\"answer\":\"Treatment involved gradual tapering of risperidone, benztropine for symptomatic relief, and initiation of aripiprazole to maintain psychiatric stability. Symptoms markedly improved after these changes.\"}]","Previously Incarcerated Veteran - A Case of Drug-Induced Parkinsonism | PDF",1790662901,15]