Why should your 5 and 2 reflex be suppressed in those with Parkinsons?

5 and 2, a staple of emergency medicine.

5 mg of Haldol

2 mg of Ativan

IV

to calm an agitated patient.

In those with Parkinsons disease, this combination, particularly the Haldol part, should be used with extreme caution as it can exacerbate extraparamidal signs. Parkinsons results from a greatly diminished number of inhibitory dopaminergic neurons. Haldol treats psychosis by decreasing dopamine. Hence, Haldol + Parkinsons makes for a bad combination.


Source

Harvey, R. and Champe, P. Pharmacology. 2nd ed