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Delirium in Parkinson's disease — DGM MCQ

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HardDeliriumDelirium in Parkinson's diseaseDGM

An 80-year-old man with Parkinson's disease is admitted with a urinary tract infection and delirium. He has visual hallucinations and worsening rigidity. His chart includes co-careldopa, rivastigmine, haloperidol, paracetamol and senna. Which medication should be reviewed?

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Correct answer: B — Haloperidol

Haloperidol can markedly worsen motor symptoms in Parkinson's disease and should be reviewed urgently. Stopping dopaminergic therapy abruptly can also be harmful, but in this list the antipsychotic is the most unsafe contributor. Parkinson's delirium needs specialist-aware prescribing, often avoiding dopamine-blocking antipsychotics.

Reference: NICE NG71; NICE CG103