Rest of physical exam findings are normal. Acute dystonic reactions have been described with every antipsychotic. Alcohol and cocaine use increase risk. Emergency interventions other than pharmacologic treatment rarely are required. Securing the airway is necessary only rarely, when laryngeal and pharyngeal dystonic reactions place the patient at risk of imminent respiratory arrest.
Pharmacologic treatment resolves the reaction.
Anticholinergic agents - Intravenous anticholinergic agents are the treatment of choice. IV is the route of choice, with signs and symptoms often resolving within 10 minutes. The medication can be delivered IM if an IV line cannot be established, but medications will take 30 min to be absorbed. More than 1 dose may be necessary for complete resolution of dystonia. By blocking striatal cholinergic receptors, may help in balancing cholinergic and dopaminergic activity.