Schizophrenia and Parkinson's disease: challenges in management.

A 57-year-old gentleman was admitted for relapse of psychotic symptoms. He had prior diagnosis of schizophrenia and Parkinson's disease. His psychotropic medications were adjusted but his neurological symptoms worsened, mainly dysphagia. His speech and mobility also posed significant problem. Neurology department was contacted for joint management. In the event of resolution of psychotic symptoms, he was transferred to the neurology department for further management. His medication for Parkinson's disease was reviewed; a percutaneous endoscopic gastrostomy tube was inserted in stomach for feeding as dysphagia did not improve. He was transferred back to psychiatry unit for further adjustment in psychotropic medication in order to see a possible improvement in dysphagia. Minor adjustment was done in this regard in view of his mental health stability. Change of medication was not possible for the possible side effects and patient's compliance issue. He was discharged with adequate plans; follow-up arrangement and suggestions for further management.