Pleurothotonus (Pisa syndrome) Induced by an Association of Clozapine and Mirabegron

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To the Editor: Pleurothotonus or Pisa syndrome is a postural deformity occurring most commonly in the coronal plane defined by an abnormal lateral trunk flexion of more than 15°. Pisa syndrome can be classified by the angle of lateral trunk flexion as mild (< 20°) or severe (≥ 20°) and can present in a chronic or subacute form.

Case report. A 56-year-old woman with bipolar disorder (DSM-5 criteria), borderline personality disorder (DSM-5 criteria), hypercholesterolemia, and hypothyroidism presented to our clinic in February 2017 reporting left trunk flexion present for the past 2 days.