Reactions 1089 - 18 Feb 2006

SCitalopram/escitalopram

Dystonic rabbit syndrome: 2 case reportsA 41-year-old woman and a 24-year-old man developed

dystonic rabbit syndrome while receiving escitalopram andcitalopram, respectively.

The 41-year-old woman, who had worsening depressionsymptoms, stopped receiving venlafaxine and started receivingescitalopram 10 mg/day. Two weeks later, she presented witha severely depressed mood and displayed rapid, vertical,rhythmic perioral movements with lip-smacking sounds andnose-twitching, without tongue involvement; she washospitalised. Her husband reported that her abnormalmovements had started approximately 1 week prior tohospitalisation, and gradually worsened. Escitalopram wasstopped and she received IM lorazepam. By morning, themovements were reduced by approximately half and hadceased by discharge 2 weeks later.

The 24-year-old man had been receiving citalopram5 mg/day for 10 days for obsessive compulsive disorder, whenhe noticed that his nose was twitching continuously anduncomfortably, his tongue was burning without involuntarymovement, and his face was bunching up vertically. Hisconcomitant medications included betaxolol and buspirone.He stopped taking citalopram and, approximately 4 days later,his dystonia resolved. Venlafaxine was started, buspirone andbetaxolol dosages were increased, and he remitted withoutdystonia recurrence.

Author comment: "The Naranjo adverse drug reactionrating score of 9 points indicates a ‘high probability’ thatthese observations represent dystonic rabbit syndrome fromexposure to citalopram."Parvin MM, et al. Dystonic rabbit syndrome from citalopram. ClinicalNeuropharmacology 28: 289-291, No. 6, Nov-Dec 2005 - USA 801033104

» Editorial comment: There has been one previous report ofdystonia in a patient receiving citalopram [see Reactions 990 p7;800972035].

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Reactions 18 Feb 2006 No. 10890114-9954/10/1089-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved