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Letters   |    
Pisa Syndrome Induced by Paliperidone
Pei-Yin Pan, M.D.; Han-Wei Chou, M.D.; Chih-Chieh Cheng, M.D.; Yi-Chien Hsu, M.D.; Nian-Sheng Tzeng, M.D.
The Journal of Neuropsychiatry and Clinical Neurosciences 2014;26:E07-E08. doi:10.1176/appi.neuropsych.12110289
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Department of Psychiatry, Tri-Service General Hospital (P-YP, H-WC, Y-CH, N-ST)
School of Medicine (P-YP, H-WC, C-CC, Y-CH, N-ST) and Student Counseling Center (N-ST), National Defense Medical Center, Taipei, Taiwan
Dept. of Psychiatry, Tri-Service General Hospital Beitou Branch, Psychiatry, Taipei, Taiwan (H-WC)

e-mail: Nian-Sheng Tzeng, M.D., pierrens@yahoo.com.tw; pierrens@mail.ndmctsgh.edu.tw

Copyright © 2014 the American Psychiatric Association

Extract

To the Editor: Pisa syndrome, or pleurothotonus, is one type of the atypical extrapyramidal syndromes, which was first described by Ekbom et al. in 1972 and is characterized by tonic lateral flexion with slight rotation of the trunk and is worse while the patient is walking.1 Pisa syndrome could be induced by treatment with current atypical antipsychotics; however, no previous report has shown it to develop after paliperidone administration. We present a case of paliperidone-induced Pisa syndrome.

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References

Ekbom  K;  Lindholm  H;  Ljungberg  L:  New dystonic syndrome associated with butyrophenone therapy.  Z Neurol 1972; 202:94–103
[PubMed]
 
Suzuki  T;  Matsuzaka  H:  Drug-induced Pisa syndrome (pleurothotonus): epidemiology and management.  CNS Drugs 2002; 16:165–174
[CrossRef] | [PubMed]
 
Meltzer  HY;  Bobo  WV;  Nuamah  IF  et al:  Efficacy and tolerability of oral paliperidone extended-release tablets in the treatment of acute schizophrenia: pooled data from three 6-week, placebo-controlled studies.  J Clin Psychiatry 2008; 69:817–829
[CrossRef] | [PubMed]
 
Shan  JC;  Tseng  MC:  Improvement in Pisa syndrome and tardive dyskinesia following aripiprazole treatment.  J Neuropsychiatry Clin Neurosci 2009; 21:350–351
[CrossRef] | [PubMed]
 
Chen  HK;  Wu  BJ;  Shao  CH:  Drug-induced Pisa syndrome associated with aripiprazole during clozapine treatment.  Prog Neuropsychopharmacol Biol Psychiatry 2010; 34:707–708
[CrossRef] | [PubMed]
 
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