Slowness and falls in a 66-year-old taking risperidone
History
66-year-old woman referred jointly by old-age psychiatry and the movement disorders clinic. Late-onset psychotic depression treated with risperidone 2 mg daily for 18 months and bupropion 150 mg daily for 1 year. For 9 months: bilateral slowness and rigidity (left slightly worse than right), a soft voice, two falls, urinary urgency and light-headedness on standing. No rest tremor. Co-careldopa 25/100 three times daily started 4 weeks ago with little benefit. Question: drug-induced parkinsonism, or an underlying degenerative parkinsonism?
Step 1 · Preparing the DaT scan
Before booking ¹²³I-FP-CIT SPECT, which of her medicines should the referrer be asked about withholding, if it is clinically safe to do so?