Objective: The aim of this paper is to present a case of paliperidone-induced Pisa syndrome and provide treatment experience.
Method: The case report is combined with a review of the literature.
Results: A 37-year-old man had been diagnosed with paranoid-type schizophrenia for about 10 years. He received three-month treatment of paliperidone extended release (ER) at 6 mg per day, but showed a progressively Pisa-like physical position. We initially added an anticholinergic drug, but saw no improvement. The paliperidone ER was replaced by olanzapine at 10 mg per day, and the Pisa-like symptom improved after 1 month of the drug replacement.
Conclusions: We propose olanzapine as a possible replacement choice for patients with paliperidone-related Pisa syndrome.
Keywords: Pisa syndrome; dopaminergic–cholinergic imbalance; olanzapine; paliperidone.
© The Royal Australian and New Zealand College of Psychiatrists 2016.