Matthew M Parvin1, Conrad M Swartz. 1. Department of Psychiatry, Pennsylvania State University, Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA 17033-0850, USA. mparvinmd888@gmail.com
Abstract
OBJECTIVE: Two cases are described of dystonic rabbit syndrome induced by citalopram. This syndrome is a movement disorder with a 5-Hz rhythmic vertical motion of the mouth and lips without involvement of the tongue. METHOD: The patients were interviewed and examined, and additional history was taken from the medical records. The Naranjo adverse drug reaction rating scale was applied. Relevant literature was reviewed. RESULTS: Two patients developed dystonic rabbit syndrome soon after starting escitalopram 10 mg/day or citalopram 5 mg/day. Neither patient had any past or current exposure to a dopamine-blocking drug or any history of movement disorder. [Es]citalopram discontinuation led to disappearance of the movement disorder. The Naranjo scale indicates high probability of dystonic rabbit syndrome from citalopram. CONCLUSION: Citalopram can rapidly induce dystonic rabbit syndrome. This effect suggests that for some patients citalopram has neuropsychiatric effects similar to those of a dopamine-blocking antipsychotic drug. This might be of concern with patients who cannot communicate well (eg, young children; patients with dementia, developmental disabilities, or aphasia).
OBJECTIVE: Two cases are described of dystonic rabbit syndrome induced by citalopram. This syndrome is a movement disorder with a 5-Hz rhythmic vertical motion of the mouth and lips without involvement of the tongue. METHOD: The patients were interviewed and examined, and additional history was taken from the medical records. The Naranjo adverse drug reaction rating scale was applied. Relevant literature was reviewed. RESULTS: Two patients developed dystonic rabbit syndrome soon after starting escitalopram 10 mg/day or citalopram 5 mg/day. Neither patient had any past or current exposure to a dopamine-blocking drug or any history of movement disorder. [Es]citalopram discontinuation led to disappearance of the movement disorder. The Naranjo scale indicates high probability of dystonic rabbit syndrome from citalopram. CONCLUSION:Citalopram can rapidly induce dystonic rabbit syndrome. This effect suggests that for some patientscitalopram has neuropsychiatric effects similar to those of a dopamine-blocking antipsychotic drug. This might be of concern with patients who cannot communicate well (eg, young children; patients with dementia, developmental disabilities, or aphasia).
Authors: Mario Catena Dell'osso; Andrea Fagiolini; Francesca Ducci; Azadeh Masalehdan; Antonio Ciapparelli; Ellen Frank Journal: Clin Pract Epidemiol Ment Health Date: 2007-06-11