Rabbit Syndrome - an Uncommon Side Effect of Neuroleptic Therapy

Sir, Dr. Manilal Gada in his article in Indian Journal of Psychiatry, Vol. 39 No. 2, April 1997, has reported a case of Rabbit Syndrome. This is an uncommon side effect of neuroleptic therapy. I compliment Dr. Gada for reporting this case. But earlier to this report, Dr. Gangadhar et al. (1981) have reported on Rabbit Syndrome-Patchy disappearance in stage -I NREM sleep. No case of Rabbit Syndrome was observed by Dr. Bagadia et al. (1972) although their cl inical trial with Flupenthixol was conducted before 1970, earlier to the observations of Villeneue (1972) on Rabbit Syndrome. However EPS side effects were reported by Dr. Bagadia et al. (1972) with Flupenthixol in 11 out of 116 patients, when the dose was 3 mg per day or more. They were easily controlled with Trihaxyphenydyl hydrochloride 6 mg. per day Dr Manilal Gada has not mentioned dosage of Flupenthixol given to his patient either before or after Rabbit Syndrome was ameliorated. Absence of other EPS side effects is another remarkable feature of the reported case. The author In his paper has cited a few references from literature, where Rabbit Syndrome has been observed in association with other EPS side effects and in some cases even with Tardive Dyskinesia. While reading this case report one is reminded of consensus statement issued by WHO on need for justified use of anticholinergics along with neuroleptic therapy (Ayarwal, 1991).