ArticleCase reports in psychiatry2026
Persistent Tremor in Bipolar Disorder: A Case Report of Idiopathic Parkinson's Disease Superimposed on Lithium and Antipsychotic Effects.
Article in Case reports in psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Persistent Tremor in Bipolar Disorder: A Case Report of Idiopathic Parkinson's Disease Superimposed on Lithium and Antipsychotic Effects.Case reports in psychiatry · 2026Article
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Authors and funding
4 authors.
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Abstract
We report a 58-year-old woman with bipolar I disorder on long-term lithium and aripiprazole who developed a progressive asymmetric resting tremor and rigidity. Despite stopping both agents, the tremor persisted for more than a year. Dopamine transporter imaging showed reduced uptake in the left putamen, confirming idiopathic Parkinson's disease (PD) with superimposed drug-induced parkinsonism (DIP). Management included discontinuing lithium, switching aripiprazole to quetiapine to limit motor worsening, and starting carbidopa-levodopa. Motor symptoms improved, but hypomanic symptoms emerged and required psychiatric dose adjustments, while apathy remained prominent. The case illustrates diagnostic overshadowing in bipolar disorder (BD) and highlights two practical lessons. When parkinsonian signs are atypical or persist after medication changes, consider idiopathic PD rather than attributing symptoms to side effects. Care is best delivered through close collaboration between psychiatry and neurology to balance dopaminergic therapy with mood stabilization.
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