Pisa syndrome (pleurothotonus) in a polytoxicomanic patient

Abstract

We describe the case of a 33-year-old drug addict who developed Pisa syndrome (pleurothotonus) following an intoxication with tramadol, alprazolam, diazepam, bromazepam, alcohol and dothiepin. Pisa syndrome abated as the patient recovered from his intoxication. We discuss the possible causes of Pisa syndrome and suggest that high doses of the tricyclic antidepressant dothiepin might be the most appropriate explanation for the appearance of Pisa syndrome in this patient.

• Pisa Syndrome Antidepressant Drug Addict Pleurothotonus Dothiepin