2012 issue 2


Volume 28, issue 2

Case report

Extrapiramidal symptoms presented as „rabbit syndrome” in the course of risperidone treatment

Ewa Ferensztajn1, Maria Chłopocka-Woźniak1, Janusz Rybakowski1
1. Klinika Psychiatrii Dorosłych, Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu
Farmakoterapia w Psychiatrii i Neurologii, 2012, 2, 95–99
Keywords: rabbit syndrome, tardive dyskinesia, antipsychotic drugs, extrapyramidal symptoms, risperidone, clozapine


Rabbit syndrome is a rare extrapiramidal symptom induced by prolonged neuroleptic administration. It is characterized by fi ne, rapid, rhytmic movements of the perioral muscles and the masseters along a vertical axis of the mouth, without involvement of the tongue and is often misdiagnosed as a tardive dyskinesia. It shows favourable resonse to anticholinergic agents, and a deterioration after treatment with dopamine agonists. Recent treatment strategies include changing antipsychotic drug to atypical neuroleptic with anticholinergic properties, such as olanzapine or clozapine. We describe a case of a patient with bipolar disorder in the course of treatment with the drug induced rabbit syndrome. The change of treatment from risperidone to clozapine has resulted in a rapid, signifi cant reduction of symptoms.

Address for correspondence:
Lek. Ewa Ferensztajn
Klinika Psychiatrii Dorosłych
Uniwersytet Medyczny
ul. Szpitalna 27/33, 60-572 Poznań
tel. +48 61 847 50 87; fax +48 61 848 03 92
e-mail: ferensztajnewa@gmail.com