Rabbit syndrome

Accessory symptoms include seborrhea, sialorrhea, hyperhidrosis, fatigue, dysphagia, and dysarthria. A variant is rabbit syndrome, a perioral tremor. 

Schwartz M, Hocherman S Antipsychotic-induced rabbit syndrome epidemiology, management and pathophysiology. CNS Drugs 2004 18 213. [PMID 15015902]... 

One variant of TD called rabbit syndrome is characterized by fine, rapid, rhythmic movements along the vertical axis of the mouth. A recent review found 11 cases associated with atypicals, mostly risperidone (Dell Osso et al., 2007). All of the FDA-approved atypical neuroleptic labels carry the same class warning as the older neuroleptics. 

Dell Osso, M., Fagiolini, A., Ducci, F., Masalehdan, A., Ciapparelli, A., Frank, E. (2007, June 11). Newer neuroleptics and the rabbit syndrome. Clinical Practice and Epidemiology in Mental Health, 3(6), 1-19. 

Parvin M, Swatz CM. Dystonic rabbit syndrome from cita-lopram. Clin Neuropharmacol 2005 28 289-91. 

Although the neuroleptic malignant syndrome has been reported in patients taking these atypical neuroleptic drugs, it is less common than in patients taking typical neuroleptic drugs, and lithium may have increased the risk in these cases. Co-administration of lithium and risperidone has been associated with the rabbit syndrome (638), but this reaction was probably caused by the risperidone, and the role of lithium was not clear. 

Mendhekar DN. Rabbit syndrome induced by combined lithium and risperidone. Can J Psychiatry 2005 50 369. 

Rabbit syndrome is a late-onset extrapyramidal adverse effect associated with neuroleptic drugs. It is characterized by a rapid tremor of the lips and occasionally the jaw. The movements usually respond well to antiparkinsonian agents and withdrawal of neuroleptic drugs. It has been suggested that the rabbit syndrome is the clinical converse of tardive dyskinesia (338). 

Deshmukh DK, Joshi VS, Agarwal MR. Rabbit syndrome—a rare complication of long-term neuroleptic medication. Br J Psychiatry 1990 157 293. 

Neuroleptic malignant syndrome (7) and rabbit syndrome (8) have also been described. 

Mendhekar DN. Aripiprazole-induced rabbit syndrome. Aust N Z J Psychiatry 2004 38(7) 561. 

Rabbit syndrome has been reported in patients taking risperidone. 

A 38-year-old man with major depressive disorder and psychotic features developed rabbit syndrome after taking risperidone 4 mg/day and paroxetine 40 mg/ day for 4 months he was also taking simvastatin 10 mg/day, thiamine 100 mg/day, and folic acid 1 mg/ day (104). 

Co-administration of lithium and risperidone has been associated with the rabbit syndrome (105). This reaction was probably caused by the risperidone, and the role of lithium was not clear. 

Levin T, Heresco-Levy U. Risperidone-induced rabbit syndrome an unusual movement disorder caused by an atypical antipsychotic. Em Neuropsychopharmacol 1999 9(l-2) 137-9. 

Hoy JS, Alexander B. Rabbit syndrome secondary to risperidone. Pharmacotherapy 2002 22(4) 513-5. 

Mendhekar DN. Rabbit syndrome induced by combined lithium and risperidone. Can J Psychiatry 2005 50 369. Rohrbach P, Collinot JP, Vallet G. Syndrome malin des neuroleptiques induit par la risperidone. [Neuroleptic... 

Caykoylu A, Ekinci O, Kuloglu M, Deniz O. Aripiprazole-induced rabbit syndrome a case report. J Psychopharmacol... 

---