Acute Dystonic Reactions to Small Doses of Prochlorperazine

Abstract

WITH THE widespread use of phenothiazine derivatives as tranquilizing and antiemetic agents, the occurrence of extrapyramidal side reactions has become well-known.^1,2 Several reports^3,4 have called attention to dystonic reactions appearing after small doses of prochlorperazine (Compazine), but although possible confusion of these reactions with hysterical attacks has been mentioned,^5,6 it has not been emphasized. This report describes three cases of prochlorperazine-induced dystonia recently seen in psychiatric consultation, in each of which an initial diagnosis of hysteria had been made by the physician in charge of the case. Report of Cases CASE 1.— A 19-year-old woman, suffering from anxiety and depression, consulted a psychiatrist, who prescribed prochlorperazine, 10 mg orally three times a day. A total of 40 mg had been ingested in slightly over 24 hours when the patient suddenly noticed a feeling of thickness of the tongue, followed by spasms of the jaws and progressive difficulty