Internal Medicine Physician Prescribes Haldol to Parkinson’s Patient
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Case Overview
This case involves a seventy-two-year-old male, with a medical history of Parkinson’s disease, who presented to the emergency room after sustaining a deep laceration to his leg. The patient was admitted and over the next few days, the leg became severely inflamed and the patient became increasingly confused, with a sudden change in his mental status.
Shortly after, the patient began experiencing mental health status changes, and the patient’s PCP gave orders to start Haldol every four to six hours. The doctor’s physician assistant reiterated to the patient to get plenty of rest and take Haldol according the doctor’s orders. The patient’s condition continued to deteriorate to the point where he could not eat or drink and no longer had the ability to control bowel or bladder function. It was also suspected that the patient had an episode of neuroleptic malignant syndrome that went untreated during his hospital stay. Following his hospital stay, the patient was severely mentally incapacitated and was no longer able to perform activities of daily living.
Questions to the Internal Medicine expert and their responses
Was it within the standard of care for this physician to prescribe Haldol to a known Parkinson's patient?
Haloperidol is contraindicated in patients with Parkinson's disease. The medication should not have been prescribed by the PCP.
Can Haldol diminish dopamine stores and exacerbate Parkinson symptoms?
The dopamine blockade from haloperidol can dramatically worsen preexisting Parkinson's disease, and, in this case, was the most likely reason the patient became incapacitated.
About the expert
This board certified family medicine physician has nearly 20 years of practice experience, and is currently a faculty member at a private practice in Virginia. He is a recipient of the prestigious Edgar T. Beddingfield Family Practice Award, awarded to exemplary family medicine physicians. His academic and medical interests include child and adolescent health and medical humanities.

E-006273
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