This patient is most likely experiencing an acute dystonic reaction in the setting of initiation of haloperidol, a typical antipsychotic. Acute dystonia is characterized by involuntary contractions of muscles in the face, neck, larynx, extremities, and core. Patient’s eyes may become stuck in an upward gaze, they may have difficulty speaking, and they may even have trouble breathing. Treatment for dystonia includes anticholinergic medications such as benztropine or diphenhydramine. Sometimes, prescribers will prescribe anticholinergics at the same time as antipsychotics, in order to decrease the chance of a dystonic reaction. Bromocriptine is used to treat antipsychotic induced hyperprolactinemia and to treat neuroleptic malignant syndrome (NMS). NMS presents with lead pipe rigidity, catatonia, and mild hyperthermia. Naloxone is used to treat opioid overdose. Dantrolene is used to treat neuroleptic malignant syndrome which usually presents with bradykinesia, severe hyperthermia, and autonomic instability.
Publication reference : Lewis K, O'Day CS. Dystonic Reactions. [Updated 2023 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK531466/
Reference URL: https://pubmed.ncbi.nlm.nih.gov/10855379/#:~:text=The%20main%20signs%20are%20dizziness,concomitant%20medication%20and%20alcohol%20consumption.