Extended therapy for acute dystonic reactions.

Dystonic reactions to neuroleptic and antiemetic medications are commonly seen in the outpatient setting. Despite initially successful treatment in the emergency department, symptoms may later recur. We have recently seen several cases of recurrent dystonic reactions; four representative cases are reported. Three of the patients experienced no further dystonic reactions when treated appropriately as outpatients. The fourth patient was lost to follow up. Based on this experience in the pharmacology of the drugs involved in producing and treating dystonic reactions, it is recommended that patients successfully treated in the emergency department for dystonia receive continued outpatient therapy for 48 to 72 hours.