Both levodopa and neuroleptics can cause dyskinesias in a patient with Parkinson's disease complicated by psychosis. These can be distinguished by evaluating the patient and the response to various interventions.
Clinical Finding
Levodopa-Induced Dyskinesia
Neuroleptic-Induced Tardive Dyskinesia
reduction in the levodopa dose
improves
no change
increase in the levodopa dose
worsens
no change
reduction in the neuroleptic dose
no change
may improve or may cause withdrawal dyskinesia
exposure to an anti-muscarinic agent
no change
worsens
effect of amantadine
improves
no change to some improvement
relative dyskinesia
extremities greater than orofacial
orofacial greater then extremities
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