Psychopharmacology: rabbit syndrome: practice question

A Psychiatry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Psychiatry · Psychopharmacology: rabbit syndrome

Sample item

After several years of haloperidol, a man develops fast, rhythmic, vertical movements of the lips resembling a rabbit chewing. The tongue is not involved, and the movements stop in sleep. Which statement is correct?

AIt is akathisia responding to propranololBIt is a late parkinsonian variant that improves with anticholinergicsCIt is tardive dyskinesia that worsens with anticholinergicsDIt is acute dystonia needing a benzodiazepine alone

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. It is a late parkinsonian variant that improves with anticholinergics

Rabbit syndrome is a rhythmic tremor of the perioral muscles that appears late during antipsychotic treatment and is considered a variant of drug-induced parkinsonism. Unlike tardive dyskinesia, it usually improves with anticholinergic drugs or with reduced antipsychotic dose.

Option by option

A. It is akathisia responding to propranolol
Akathisia is subjective restlessness of the legs and not a perioral tremor.
B. It is a late parkinsonian variant that improves with anticholinergics (correct)
Correct. Parkinsonian variant that improves with anticholinergics.
C. It is tardive dyskinesia that worsens with anticholinergics
Tardive dyskinesia has choreoathetoid tongue and orofacial movements and is not improved by anticholinergics.
D. It is acute dystonia needing a benzodiazepine alone
Acute dystonia occurs early after starting an antipsychotic with sustained muscle spasms, not rhythmic perioral tremor.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is B, It is a late parkinsonian variant that improves with anticholinergics. Rabbit syndrome is a rhythmic tremor of the perioral muscles that appears late during antipsychotic treatment and is considered a variant of drug-induced parkinsonism.

Why is "It is akathisia responding to propranolol" not the answer?

Akathisia is subjective restlessness of the legs and not a perioral tremor.

Why is "It is tardive dyskinesia that worsens with anticholinergics" not the answer?

Tardive dyskinesia has choreoathetoid tongue and orofacial movements and is not improved by anticholinergics.

Why is "It is acute dystonia needing a benzodiazepine alone" not the answer?

Acute dystonia occurs early after starting an antipsychotic with sustained muscle spasms, not rhythmic perioral tremor.

What concept does this question test?

It tests Psychopharmacology: rabbit syndrome in Psychiatry. Unlike tardive dyskinesia, it usually improves with anticholinergic drugs or with reduced antipsychotic dose.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Psychopharmacology: rabbit syndrome?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.