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Amisulpride-induced late-onset rabbit syndrome: Case report and literature review

Published online by Cambridge University Press:  01 September 2022

I. Gundogmus ,
S. Tekin ,
A. Tasdelen Kul ,
Ö. Uzun  and
K.N. Ozmenler
I. Gundogmus
Affiliation:
Kirikkale Yuksek Ihtisas Hospital, Psychiatry, Kırıkkale, Turkey
S. Tekin*
Affiliation:
Gulhane Research and Training Hospital, Psychiatry, Ankara, Turkey
A. Tasdelen Kul
Affiliation:
Gulhane Research and Training Hospital, Psychiatry, Ankara, Turkey
Ö. Uzun
Affiliation:
Gulhane Research and Training Hospital, Psychiatry, Ankara, Turkey
K.N. Ozmenler
Affiliation:
Gulhane Research and Training Hospital, Psychiatry, Ankara, Turkey
*
*Corresponding author.

Abstract

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Introduction

Amisulpride is an atypical antipsychotic. Rabbit syndrome(RS) may be seen after antipsychotics use a few days or long‐term application. RS occurs after more frequent typical antipsychotics and also in rare cases atypical antipsychotics.Its characterized by the involuntary rhythmic movements of the lips however involves no tongue movements.

Objectives

Case report and reflection on its etiology

Methods

Case report and literature review

Results

A 28-year-old female with a diagnosis of schizophrenia applied with the complaints and symptoms of withdrawal, do not want to leave the house, physical anergy and avolition that started after stopped taking her medications. She was admitted to the psychiatry service and amisulpride treatment was started and was gradually increased to 800 mg/day. After 30 days of hospitalization, the patient was discharged with mild recovery. 14 days after the discharge, because of the abnormal involuntary movements in mouth, the patient applied. In clinical examination without tounge involvement, rhythmic motions were observed in the lips and jaw.Neurological examination, labrotory tests and cranial screening were all normal. She was evaluated by a private psychiatrist and was diagnosed with RS. Amisulpride treatment changed to olanzapine treatment with 15 mg/day. After two months, RS spontaneously regressed.

Conclusions

The resolution of the involuntary movements following discontinuation of amisulpride in our case, supported the diagnosis of RS. Although the mechanism by which RS emerges as a side‐effect of amisulpride is not fully understood, the drug’s high affinity for and selective binding to dopaminergic D2 and D3 receptors are thought to be responsible for this involuntary motion disorder.

Disclosure

No significant relationships.

Keywords

Antipsychotics side-effectsamisulpriderabbit syndrome,
Type
Abstract
Information
European Psychiatry , Volume 65 , Special Issue S1: Abstracts of the 30th European Congress of Psychiatry , June 2022 , pp. S712
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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