Long-acting Injectable Aripiprazole (Abilify Maintena) Induced Rabbit Syndrome: A Case Report and Review of the...

Area of Science:

• Psychiatry
• Pharmacology
• Neurology

Background:

• Rabbit syndrome (RS) is an orofacial movement disorder typically associated with antipsychotic use.
• Recent data suggest newer antipsychotics may also induce RS.
• Long-acting injectable antipsychotics (LAIs) are increasingly used for chronic conditions like schizophrenia and bipolar disorder.

Observation:

• A 53-year-old male with bipolar I disorder developed RS seven months after initiating Abilify Maintena (aripiprazole lauroxil) 400 mg.
• The patient had persistent manic episodes despite previous treatments.
• RS symptoms were characterized by fine, rapid, rhythmic movements along the mouth's vertical axis and were resistant to dose adjustments.

Findings:

• This case report documents RS in a patient treated with a newer-generation LAI, Abilify Maintena.
• The onset of RS occurred several months after treatment initiation, suggesting a potential association.
• The symptoms persisted despite attempts to manage them through medication adjustments.

Implications:

• Clinicians should maintain vigilance for RS as a potential adverse effect of LAIs, particularly newer formulations.
• Further research is warranted to elucidate the mechanisms underlying RS associated with LAIs.
• Optimal management strategies for RS in patients receiving LAIs require further investigation.