Incidence of dystonic reactions is greater in males than in females. The risk of reaction decreases as age increases. Onset of symptoms is sudden, usually within minutes to days of initiating or increasing dose of causative agent. Obtain history from others if patient is not able to speak. Mental status is unaffected.
Vital signs are usually normal.
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.