Abstract

LEVOSULPIRIDE INDUCED ACUTE WORSENING OF PARKINSONIAN MANIFESTATIONS: A CASE OF PROGRESSIVE SUPRANUCLEAR PALSY (PSP)

Jiya Thankam Koshy*, Nikhil Gladson, Abraham Kurien and Vimod K. Wills

ABSTRACT

Drug-induced Parkinsonism is often known to be caused primarily by Antipsychotics (Neuroleptics), specifically the extrapyramidal symptoms (EPS) of such drugs are believed to be due to the blocking of the Dopaminergic D2 receptor in the Nigrostriatal pathway of the brain. Typically, newer antipsychotics like Levosulpiride inducing such effects are often unrecognized. Levosulpiride is frequently noted with clinical manifestations such as Parkinsonism, isolated tremors, and Tardive dyskinesia. We depict a 73 years old male patient with a known case of Progressive Supranuclear Palsy (PSP) who presented with acute worsening of Parkinsonian symptoms of 3 weeks duration. He had been taking the combination drug, Levosulpiride + Esomeprazole for dyspepsia for the past 1 year. Levosulpiride drug was discontinued for 1-week following which patient showed a significant improvement in view to his gait imbalance symptoms. This report aims to emphasize this incidence and to increase the awareness among clinicians and other health care professionals regarding the extrapyramidal side effects of Levosulpiride when it comes to prescribing them to patients for minor ailments.

Keywords: Antipsychotics (Neuroleptics), Extrapyramidal symptoms (EPS), Levosulpiride, Progressive Supranuclear Palsy (PSP).