What is your approach to managing a patient with a history of tardive dyskinesia on a VMAT2 inhibitor, presenting with parkinsonism and found to have an abnormal DAT scan?  

I have seen multiple experts use both VMAT2 inhibitors and levodopa simultaneously in these instances, though reluctantly so. It depends on the severity of TD and PD (which is obviously exacerbated by VMAT2 inhibitors) and which symptoms are most bothersome for the patient.  Some options inclu...