Acute Extrapyramidal Side Effects from Smoked Haloperidol.

Area of Science:

• Psychiatry
• Pharmacology

Background:

• Haloperidol, a typical antipsychotic, is prescribed for psychotic disorders.
• High-dose haloperidol increases the risk of extrapyramidal symptoms (EPS).
• Limited literature exists on haloperidol misuse.

Observation:

• A patient with schizophrenia misused haloperidol by smoking it with marijuana.
• Following consumption, the patient presented with suicidal ideation, psychosis, and acute dystonia.
• Dystonia resolved rapidly after diphenhydramine administration in the emergency department.

Findings:

• This is the first reported case of haloperidol misuse through smoking.
• Concurrent use of marijuana with haloperidol may precipitate acute dystonic reactions.

Implications:

• Clinicians must consider unconventional routes of prescribed antipsychotic misuse.
• Awareness of combined substance use is crucial for managing adverse events.
• This case underscores the importance of patient education on proper medication use.