Drug-induced psychosis is a serious late complication of Parkinson's
disease (PD) that requires aggressive treatment. Recent studies have found
clozapine a highly effective and ECT a possibly useful intervention. Two
cases are presented that illustrate a possible treatment role for ECT. The
cases demonstrate that ECT has significant but short-lived antipsychotic
effects when used alone. However, patients who do not respond to clozapine
monotherapy can be given adjunctive treatment with ECT. The combination
therapy resulted in abrupt alleviation of psychotic symptoms in one of the
cases, and maintenance with low-dose clozapine allowed for long-term
efficacy. On the basis of these findings, a therapeutic approach to
patients with drug-induced psychosis in PD is suggested.
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