An acute dystonic reaction with long-term use of ranitidine in an intensive care unit patient

Dystonic reactions produce twisting and repetitive movements or abnormal posturing; this sign is considered an extrapyramidal sequela that is most typically thought to arise from decreased dopamine activity in the basal ganglia. Severe dystonic reactions have been shown to occur in concert with numerous medications. Although most commonly described with anti-psychotic agents such as haloperidol and phenothiazine, dystonic reactions have been observed in those who have used fluoxetine, erythromycin, crack cocaine, phenobarbital, cisapride, and buspirone. This report details the case of a patient who developed an acute dystonic reaction while taking ranitidine for peptic ulcer prophylaxis, a complication that, to our knowledge, has yet to be described with the use of this agent.