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Dystonic rabbit syndrome from citalopram
Matthew M Parvin1, Conrad M Swartz
1Department of Psychiatry, Pennsylvania State University, Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA 17033-0850, USA. mparvinmd888@gmail.com
Clinical Neuropharmacology
|December 13, 2005
Summary
Citalopram can cause dystonic rabbit syndrome, a movement disorder affecting the mouth. Discontinuation of the drug resolved the condition in two patients, suggesting a link between citalopram and this adverse effect.
Area of Science:
- Neuropharmacology
- Movement Disorders
Background:
- Selective serotonin reuptake inhibitors (SSRIs) like citalopram are widely prescribed.
- Movement disorders are potential adverse effects of certain medications.
Observation:
- Two patients developed dystonic rabbit syndrome, characterized by rhythmic mouth movements, after initiating citalopram or escitalopram.
- No prior history of movement disorders or exposure to dopamine-blocking agents was noted.
Findings:
- Citalopram, at a dose of 5 mg/day, was strongly implicated in inducing dystonic rabbit syndrome based on the Naranjo scale.
- Escitalopram, at 10 mg/day, was also associated with the syndrome.
- Discontinuation of the implicated medication led to the resolution of symptoms in both cases.
Implications:
- Citalopram may exhibit dopamine-blocking-like neuropsychiatric effects in some individuals.
- Caution is advised when prescribing citalopram to patients with communication difficulties, such as young children or those with cognitive impairments.