Pisa syndrome during aripiprazole treatment: a case report

Pisa syndrome (or pleurothotonus), consisting of a tonic flexion of the trunk, has been recently reported also in association with atypical antipsychotics. We describe the first case of Pisa syndrome during aripiprazole treatment in an elderly (77-year-old) woman, admitted to hospital for behavioural and psychological symptoms of dementia. The ongoing treatment with quetiapine was rapidly tapered and stopped, and a switch to aripiprazole (15 mg/die) was attempted the subsequent day. Six days later, an acute tonic flexion of trunk and head towards the right was observed. Aripiprazole was discontinued and the Pisa syndrome completely disappeared within 3 days, without any adjunctive treatment.