Clozapine for Parkinson’s disease psychosis in a septuagenarian: a nightmare turned into bliss

Abstract

Parkinson’s disease psychosis, characterized by confusion, visual hallucinations, and delusions is a nightmare for the patients and caregivers. Classic neuroleptics aggravate the motor symptoms, hence the need for an effective atypical antipsychotic. Currently Pimavanserin is the only approved drug for Parkinson’s disease psychosis (PDP), however it is not readily available. Clozapine with its excellent anti psychotic profile, without worsening of motor features, cost effectiveness and easy availability transcends all boundaries in improving the Quality of life in PD patients with psychosis. We describe an elderly patient with PDP with an excellent response to low dose clozapine. © Fondazione Società Italiana di Neurologia 2024.