{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T23:51:53Z","timestamp":1777679513326,"version":"3.51.4"},"reference-count":51,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T00:00:00Z","timestamp":1770336000000},"content-version":"vor","delay-in-days":36,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Psychiatry"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>We report a 58\u2010year\u2010old woman with bipolar I disorder on long\u2010term 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\u2019s disease (PD) with superimposed drug\u2010induced parkinsonism (DIP). Management included discontinuing lithium, switching aripiprazole to quetiapine to limit motor worsening, and starting carbidopa\u2013levodopa. 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.<\/jats:p>","DOI":"10.1155\/crps\/5580753","type":"journal-article","created":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T11:31:02Z","timestamp":1770377462000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Persistent Tremor in Bipolar Disorder: A Case Report of Idiopathic Parkinson\u2019s Disease Superimposed on Lithium and Antipsychotic Effects"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0416-469X","authenticated-orcid":false,"given":"Ethan","family":"Jetter","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6959-9344","authenticated-orcid":false,"given":"Daisy","family":"Valle","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3589-0239","authenticated-orcid":false,"given":"Diego","family":"Nolasco","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7771-4886","authenticated-orcid":false,"given":"Brent","family":"Carr","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,2,6]]},"reference":[{"key":"e_1_2_10_1_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000007649"},{"key":"e_1_2_10_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2022.3902"},{"key":"e_1_2_10_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2019.3446"},{"key":"e_1_2_10_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2020.08.031"},{"key":"e_1_2_10_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2022.120192"},{"key":"e_1_2_10_6_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1041610216001101"},{"key":"e_1_2_10_7_2","doi-asserted-by":"publisher","DOI":"10.2165\/11598540-000000000-00000"},{"key":"e_1_2_10_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/mds.70135"},{"key":"e_1_2_10_9_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41531-024-00794-z"},{"key":"e_1_2_10_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40345-016-0068-y"},{"key":"e_1_2_10_11_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ki.5002578"},{"key":"e_1_2_10_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/mds.27602"},{"key":"e_1_2_10_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-009-5039-0"},{"key":"e_1_2_10_14_2","doi-asserted-by":"publisher","DOI":"10.3988\/jcn.2012.8.1.15"},{"key":"e_1_2_10_15_2","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.2008.073312"},{"key":"e_1_2_10_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2025.111683"},{"key":"e_1_2_10_17_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.51.6.850"},{"key":"e_1_2_10_18_2","doi-asserted-by":"publisher","DOI":"10.1176\/jnp.2.1.64"},{"key":"e_1_2_10_19_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2018.00018"},{"key":"e_1_2_10_20_2","doi-asserted-by":"publisher","DOI":"10.2147\/TCRM.S360268"},{"key":"e_1_2_10_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(06)70549-X"},{"key":"e_1_2_10_22_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.2003.tb07458.x"},{"key":"e_1_2_10_23_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.14-0970"},{"key":"e_1_2_10_24_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41531-025-00874-8"},{"key":"e_1_2_10_25_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnagi.2024.1418751"},{"key":"e_1_2_10_26_2","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.3416"},{"key":"e_1_2_10_27_2","unstructured":"Updates in diagnostic testing in Parkinson disease US Health Connect 2025 Accessed September 21https:\/\/practicalneurology.com\/diseases-diagnoses\/movement-disorders\/updates-in-diagnostic-testing-in-parkinson-disease\/32164\/."},{"key":"e_1_2_10_28_2","doi-asserted-by":"publisher","DOI":"10.1111\/ene.12444"},{"key":"e_1_2_10_29_2","doi-asserted-by":"publisher","DOI":"10.3390\/clinpract13060128"},{"key":"e_1_2_10_30_2","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/5139237"},{"key":"e_1_2_10_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2014.01.001"},{"key":"e_1_2_10_32_2","doi-asserted-by":"publisher","DOI":"10.14802\/jmd.24227"},{"key":"e_1_2_10_33_2","doi-asserted-by":"publisher","DOI":"10.1002\/npr2.12235"},{"key":"e_1_2_10_34_2","doi-asserted-by":"publisher","DOI":"10.5350\/DAJPN2018310313"},{"key":"e_1_2_10_35_2","doi-asserted-by":"publisher","DOI":"10.1186\/1752-1947-3-6448"},{"key":"e_1_2_10_36_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.86258"},{"key":"e_1_2_10_37_2","doi-asserted-by":"publisher","DOI":"10.1177\/08919887231154933"},{"key":"e_1_2_10_38_2","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines12102317"},{"key":"e_1_2_10_39_2","doi-asserted-by":"publisher","DOI":"10.1002\/mds.23884"},{"key":"e_1_2_10_40_2","doi-asserted-by":"publisher","DOI":"10.2147\/NDT.S371641"},{"key":"e_1_2_10_41_2","doi-asserted-by":"publisher","DOI":"10.1080\/14656566.2025.2481205"},{"key":"e_1_2_10_42_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.prdoa.2025.100317"},{"key":"e_1_2_10_43_2","doi-asserted-by":"publisher","DOI":"10.1080\/14656566.2021.1942455"},{"key":"e_1_2_10_44_2","first-page":"66","article-title":"Association Between Bipolar Disorder and Parkinson\u2019s Disease","volume":"35","author":"de Merxem R. G.","year":"2023","journal-title":"Psychiatria Danubina"},{"key":"e_1_2_10_45_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2025.02.044"},{"key":"e_1_2_10_46_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3182516244"},{"key":"e_1_2_10_47_2","doi-asserted-by":"publisher","DOI":"10.1038\/s44220-024-00256-8"},{"key":"e_1_2_10_48_2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.163.2.232"},{"key":"e_1_2_10_49_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1041610210001687"},{"key":"e_1_2_10_50_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12883-022-02668-4"},{"key":"e_1_2_10_51_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.prdoa.2021.100096"}],"container-title":["Case Reports in Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/crps\/5580753","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/crps\/5580753","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/crps\/5580753","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T08:10:14Z","timestamp":1772957414000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/crps\/5580753"}},"subtitle":[],"editor":[{"given":"Edo S.","family":"Jaya","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":51,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/crps\/5580753"],"URL":"https:\/\/doi.org\/10.1155\/crps\/5580753","archive":["Portico"],"relation":{},"ISSN":["2090-682X","2090-6838"],"issn-type":[{"value":"2090-682X","type":"print"},{"value":"2090-6838","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-11-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"5580753"}}