Idiopathic Parkinson #x2019;s disease and Schizophrenia: Dilemma in diagnosis and treatment

The relationship between schizophrenia and idiopathic Parkinson #x2019;s disease is still not clear and rare when they coexist. Diagnosing coexisting schizophrenia and idiopathic Parkinson #x2019;s disease is a challenge, especially in developing countries due to lack of experts and advance imaging facilities. Treatment options are also limited. A 58 year old male was admitted due to relapse of psychotic symptoms following noncompliance to antipsychotic medications. The patient was previously diagnosed with schizophrenia and later developed Parkinson #x2019;s disease while noncompliant to antipsychotic medications. While the patient was at our center, his detailed history was taken and general physical examination was done to distinguish Parkinson #x2019;s disease from antipsychotic induced extrapyramidal symptoms. All the routine investigations were within normal limits. This case report highlights the clinical factors that help make a distinction and help use appropriate drugs to manage schizophrenia with comorbid Parkinson #x2019;s disease in developing countries, where lack of precise diagnostic imaging modalities interferes in making a conclusive diagnosis.