Acute Dystonic Reaction

[@Jiffybob47]

he is so sweet. i'm so sorry you had this crisis.

[@lfrohling]

What a brave young man! Thank you young man for letting us join you at this sensitive time in your life

[@dml9699]

LMAO ... we will be billionaire's DOC we have found the cure for SCHIZOPHRENIA ! We can split it 50/50 I had no clue 50 of Benadryl was "something kinda like WEED" could make you feel that GOOD ! Bless his heart .

[@saraht1291]

I concur, thank you very much. Your willingness to share is very brave of you!

[@RooseveltAliWashingtonX]

50 milligrams of intravenous Benadryl would probably cause me to sleep for 12 hours straight! I find it remarkable that he's so slert and steady on his feet.

[@katieh3236]

such a respectful young man

[@ventilator98]

I LOVE the ER. When Im there its weirddc but all the nurses are like "You know more about this stuff than we do." Its a long story, but I have many health issues and use a ventilator and several other pieces of equipment. When Im in the ER there isn't much sports talk. There isn't any. I'm there talkinga bout ECMO, HFOV, RSI, Procedural induction, telling them what to hook me up to, ECG, NBP, SPO2, ETco2, man its awesome. ITS PURELY AWESOME.

[@mozafarahmed6041]

Great video. Thank you for highlighting such a serious medication side effect

[@lmellick]

Thank you!!

[@lmellick]

Emedicine describes the mechanism better than I can. "They appear to result from drug-induced alteration of dopaminergic-cholinergic balance in the nigrostriatum (ie, basal ganglia). Most drugs produce dystonic reactions by nigrostriatal dopamine D2 receptor blockade, which leads to an excess of striatal cholinergic output." However, I don't think the location of the injection makes any difference.

[@Eric91531]

I take Benadryl to help me sleep. I use it for allergic reactions, I use it to calm me down after I take in too much caffeine from coffee. The only downside is the temporary mental blocks. My thoughts are not clear, especially if your studying in school.

[@IvanTheGr8est]

I hope you split the proceeds of this video 50/50! Great content. PANCE in 1.5 days definitely not forgetting ADR now!

[@Not_a_snake]

During anaphylactic reactions I've had high doses of benedryl, it's kind of a head rush. Apparently, it made this guy feel fantastic though.

[@Len_M.]

Katie With really high doses of Benadryl it becomes psychoactive.

[@AnniaDamarys]

Lol "he figure out the cure for everything. Something like weed..." 😂😂😂😂

[@margolin89]

I like ur videos I stayed up till 5am watching them

[@lmellick]

You are welcome!

[@ciggytardust]

Hey there- I've got a few questions for you if you've got the time! I assume that this young man was being treated for schizophrenia, given his list of medications. 1. Why did you choose to use a diphenhydramine injection instead of something like a benztropine injection to treat the acute dystonia? I know that hospitals are more likely to have the diphenhydramine on hand, but the benztropine seems to have far fewer potential negative interactions with his current medications. I did hear the young man's mother say that he had taken his first dose of oral benztropine at 7pm that evening. 2. Clearly the intravenous diphenhydramine induced a pretty marked and rapid transition into mania/psychosis. Aside from attempting to treat with benzodiazepines as well as a referred trip to the psychiatrist, what might some other possible steps forward be? Would psychiatric hospitalization be recommended at the time of this episode for further stabilization? I assume that there will also be a potential cutback on his current medications and dosages upon further review with his psychiatrist. I'd love to hear your thoughts, and thanks for taking the time to read! -Kelsey

[@lmellick]

It really boils down to using what we have immediately available in the ED. And, everything you mention would be appropriate therapy and follow-up.

[@four4vizslas]

Ditto on this comment. As far as the patient in the video, at least the patient was talking about GIVING the doctor and hospital money and not yelling at the staff that he was going to SUE everyone!!!

[@satearraoyemakinwa7978]

I wished the doctors continued to push the benadryl while we have Sickle cell pain crisis. It helps and calms the jumping nerves. And the meds on top combined is genius. P.s I only take meds for real severe crisis.

[@EmmaChasteen-g7z]

I thought they did. I follow someone who suffers from sickle cell crisis and does get the benadryl push and something called gravol)spelling?)

[@satearraoyemakinwa7978]

@@EmmaChasteen-g7z hey there only some people will do it. But lately they have been saying that they don’t do anymore.

[@MartianSA]

We gon' be billionaires! Don't forget to split it 50 50, doc! LOOOL

[@lmellick]

Yes, it contributed.

[@MegaJunebug420]

great educational video doctor, thank you for sharing with us.

[@FleaRHCP97]

I find it very strange that people don't talk more about compazine-induced panic attacks. SO common.

[@stupidfish2]

i tell all the people about my dystonias from abilify, risperidon, latuda, olanzapin, haloperidol ........ nobody listen to me, they think its part of my paranoid psychosis, very anoing

[@kevk741]

It’s acute akathisia, not a “panic attacks”. That is a neurotoxic reaction occurring. That “panic” or akathisia can become chronic and last decades. Dopamine antagonists cause akathisia. It’s criminal.

[@Land_of_Archives]

​I have taken each of those meds as well plus more and those reactions are very scary shit and traumatizing as can get. I haven't had one for those meds for 5 months and still have remnants of the dystonia and extreme panic fairly intense but not as intense as in the reactions. They also give the wrong meds for the reactions as they are nervous system reactions not allergic reactions. Ativan helps those reactions usually within 10 minutes and they will give Benadryl and cojentin for them while the reaction still goes on for days when they couldve just given 1 dose of ativan ​@@stupidfish2

[@lmellick]

Also, these reactons are not typical Parkinson's symptoms...for whatever reason.

[@fondawilliam8371]

sometimes just overexercising, stress, or too many stimulants can cause that, nothing to be worried about it's temporary I'M SURE.

[@DigitalAndInnovation]

I would be happy to see this doctor connect at a deeper level with the patient considering the 50 mg Benadryl regimen worked. Telling him he was a "little wild" seemed counter-intuitive.

[@AesthMed]

You do not play along with people's delusions. Saying "It's a little wild in here for me." Is a bit nicer than shutting the young man down during his delusion. The doc even gave him lorazepam later, according to the video. I'm assuming due to his delusional and erratic behavior toward the end.

[@kevinday107]

I wish I NEVER had taken antipsychotics. They literally ruined my health. But then again it's a double edged sword to be blunt; either go crazy and die, or take the pills and suffer long term going crazy a 2nd time suffering a slow lonely death. I don't have Scitzophrenia, but I know these meds are used for a wide variety of disorders that sometimes are even interlinked or caused by each other. Of course it didnt help that government the funded mental health dr dropped the ball on lab tests and my complaints of side effects were igbored before it was too late. God bless those who absolutely must continue to take these meds at such high doses. I've never actually met anyone who mentioned they did NOT experience any medical side effects on these meds.

[@dml9699]

Okay kids DO NOT GO cleaning out the stores trying to get high off BENADRYL ...LOL

[@fondawilliam8371]

Don't do drugs and I don't want to be geeked up at all, but I do value knowledge.

[@fondawilliam8371]

and medicaid is needed for these cases, i would fall apart without it.

[@pony8136]

This guy looks like LeBron James.

[@ventilator98]

I use NIV Non-Invasive Ventilation with a Mask in the MOde SIMV, or Assist/Control. So the ventilator does the work for me, but if I breathe It will give me pressure support. I do NOT have a trach.

[@vr00m123]

Hi Dr. Mellick. In neuroscience, we've learned about medication targeted for schizophrenics causing a drop in dopamine. Thus causing Parkinson's like symptoms. Would you say that this is one of those cases? Did the location of the injection have anything to do with the problem?

[@fondawilliam8371]

YOU LIVE YOU LEARN.

[@jemalynn]

I've had A phew cases of dystonic reaction and had to go to the ER and they are crazy! Even my tongue was spasming. This guy said he didn't have any pain but wow I sure was in pain with each of mine! Anyone else?

[@bobwilson7066]

This is a pretty mild case. When I had a dystonic reaction I had a full body convulsions. They took forever to give me that shot of benadryl. But once they did it was cleared up completely.

[@omarmaamouri]

The Mighty DIPHENHYDRAMINE!!!

[@RubyCoughDrop]

Omar Ali 89 I mean I like Benadryl but damn

[@fondawilliam8371]

BUT DOCTORS DON'T TELL YOU THAT

[@brianlitteral4316]

He better split it 50/50

[@amyahlquist3436]

Haldol caused my whole jaw to lock up so bad my teeth were cutting into my cheeks. Benadryl I took just to sedate myself but I noticed my jaw and cheek muscles let go. Turns out I inadvertently took the treatment for this problem.

[@DavePryor302]

Dam my girl takes those meds for schizophrenia

[@kristykellytube]

I have had dystonic reactions to: reglan, compazine, inapseine and haldol. Is Lyrica a safe drug for someone susceptible to these reactions? Btw..Dr. James Fick did my brain surgery several yrs ago at MCG. Amazing staff and hospital!

[@Chelb0215]

LoL I couldn't help but giggle when he started laughing. I noticed mom crept into video at 4:15.

[@fondawilliam8371]

they should have just sent him to jail and restrained them to help arrived, instead he has to deal with being bullied and limited job prospects and things of that nature and being outast because of this, but it doesn't mean he can't just comply with his medication regiment from now on and push through and succeed.

[@AlexGoMAD]

Euphoric reaction to Benadryl? What?

[@jcreen7]

+AlexGoMAD it's because of the hypnotic effects of Diphenhydramine.

[@nikkihackborn8472]

AlexGoMAD I had that when I was given IV Benadryl. I was given that and prednisone for anaphylactic reaction

[@ballistaproductions]

AlexGoMAD i've felt that before when i drunk half a bottle of it

[@yezper6828]

Risperdal and Invega is usually used to treat schizophrenia.

[@stupidfish2]

in my europe country invega is not that common. whats common is olanzapine and risperidon (i am schizo patient suffering from dystonia) my doc told me that its hard to tell if its real dystonia or if it is dissoziative attack, would guess that maybe the antidot would even work if it would be dissoziative breakdown. but biperiden (the anticholinergic drug used in europe against Risperdal/otherNL induced dystonia) works quite good for me, but just intravenous, the pills are no help for me! in the ambulance car there was no biperiden or other anticholinergic substance so i had to wait with my dystonic throat cramps grasping for breath til i was in the hospital.

[@fondawilliam8371]

Location has nothing to do with it they can be caused by pills, and needles alike you are a newbie training student or something?

[@La_to_the_Bay]

He some where popping Benadryl chasing that high. Just kidding

[@lovelynurse2000]

I believe that I have seen 2 videos on dystonic reaction to risperidone. Do other antipsychotics cause acute dystonic reaction? I have been taking Seroquel for 5 years at bedtime to help with racing thoughts and sleep disturbance. I have never had any problems with it. Current dosage is 300 mg nightly.

[@tweelet]

The last time I wound up in the ER was such a HELL experience which ended me up in the "psych ward", same as being in JAIL to me!!!!, I've had so damn many schizo this and that "bullshit" thrown my sad aspergers way. I will never, NEVER!!!!!! ever again go in the hospital er again, I dont care if I'm dying, literally. If the "awesome days long gone sadly" where OPIATES(Opium) was still prescribed for depression, I would not have to go to da MMT clinic anymore. PLEASE history repeat again Opiates

[@fondawilliam8371]

As long as you don't walk around looking like micheal j fox nobody is even going to notice or care, and it could be compulsive as well as involuntary.

[@meecenator25]

The older style antipsychotics like haloperdol, loxapine and thorazine can cause dystonia.

[@tiffanygooodin3360]

IV benadryl Never made me feel that way I get more like anxiety attack can't stop walking around for hour's feeling I hate it!!

[@ryanlewis194]

I tried seraqal for insomnia and ended up in ER at 2 am w hallucinations and all kinds of crazy stuff. Scared the S#it out my family. So they gave me Zyprexia/ Zyprexa /? Apperently, I passed out and started grinding teeth and having a "herx" reaction then blood sugar dropped. I saw tons of colors. Needless to say I'll never try any meds again. I'll stick w the medical marijuana. F that.

[@JESUSSavedMefromDeath]

Ryan Lewis I read that Seroquel should only be used to treat psychotic diseases.

[@bluekeet]

Ryan Lewis the blood sugar problems came with the zyprexa.

[@shive0694]

Is Geodon known to cause similar side effects?

[@fondawilliam8371]

Just behave yourself because you never know what a huge shot of sedatives can do, I'm sure they know the safe dosage.

[@m2inla]

ive had 2 patients like that, but both were biting their tongue as a result of their dystonic reaction. one was 5 minutes away from the nearest ed but i still gave 50 mg diphenhydrazimine iv because he looked like he was going to bite his tongue off as a result of his psych meds.

[@akc121783]

he can hardly speak being so heavily medicated. i feel bad for this kid.

[@micheaelbulikov9281]

ne too. mental illness sucks. here, take another pill to add on to the plethora of pills you're already taking... sigh.

[@akc121783]

ne too. mental illness sucks. here, take another pill to add on to the plethora of pills you're already taking... sigh.

[@camronnorman2842]

ne too. mental illness sucks. here, take another pill to add on to the plethora of pills you're already taking... sigh.

[@PhilipKNguyen]

bro sounded like mike tyson!

[@retriverlover97]

If you don't mind me asking by antipsycotic medication do you mean that he has some mental illness?

[@AesthMed]

Yes.

[@lmellick]

Thank you! Now get some sleep!

[@thegeekyhokage7230]

the patient is really cute! :)

[@emmiqueen]

My brother has risperidone shots every 2 weeks...if he was given oral benadryl (otc tablets for allergies) would he be at risk of having a reaction like this? Thank you.

[@AesthMed]

IV benadryl tends to have more potent effects than oral.

[@emilyexorcismzombie]

Grandiose type delusions as well? (student nurse)

[@PunkNation26]

Nurse Girly Psychosis tends to revolve around what the person suffering from it fears most.

[@fondawilliam8371]

uh yeah! it's common for spasms and dystonic reactions to occur with all the psychotropics, so once your scewed your screwed, why you can't sue doctors or big pharma for this is a tragedy. He's not being honest if it says it just happens once in a while, you hit a doctor once and you can expect to be on this crap for life.

[@four4vizslas]

Why do you need to talk about RSI if you have a treach and use a venilator? I would assume you have a treach if you are able to use a ventilator at home; unless you are talking about using CPAP only at home with a mask. I do not think it is good to like the ER. If you are happy and feeling well when you are in the ER, why do you have to go to the ER?

[@Aelita3575]

I have a question myself. I seem to have similar attacks, shown in my video that I will link. I think I may have Dystonia after a larger attack many years ago after taking a nausea medication. My neurologist seems to have no answers and just says it's a panic attack. Please watch and tell me what you think, symptoms listed on video. Thanks. kzbin.info/www/bejne/l4PVp6lte9yNntU

[@iguanakilla]

Wow that benadryl looked like it was pushed fast

[@RooseveltAliWashingtonX]

The Benadryl was diluted in a prefilled, normal saline (NS) syringe. I presume that the syringe contained one milliliter of drug, to nine milliliters of NS. Therefore, it was safe to push faster than normal.

[@DavePryor302]

I had this I believe. Can it cause your jaw to tense up instead of opening? I had to put a wallet in my mouth to keep my teeth and tongue safe because I was afraid id break my teeth or bite my tongue

[@nataliegrace7820]

I had a dystonic reaction to depicote in February

[@ryanlewis194]

Big pharmacy side effects

[@fullnelsondnb]

How about Marinol?

[@OnlyZunkin]

Theodore Nelson This guy was not being treated with nueroleptics for nausea, but regardless, you make a damn good point. It is borderline criminal to treat people with nueroleptic anti-emetics that can cause permanent nuerological damage when a comparatively harmless and more efficacious medication such as Marinol is available for treating nausea. I'm sure if the doctor's told their patients that they have a choice between a medication that can potentially cause them permanent brain damage or one that might give them the munchies and make the slightly high, that they would choose the later just about every time.

[@richardkeith7571]

Melting Sky, Exactly agree, my aunt was on Welbutrin for years, when she turned 40 she showed signs of Alzheimer's. The Dr wean her off the prescription but the syptoms just kept getting worse, after time the antipsychotics help reroute the brain. She can no longer speak they ran several tests, no stroke, no tumor. Shes like a person without a sole, zombie like. Instead if expiromenting on people like lab rats, I think the psychiatrist's should try the drug and see for themselves how it makes them feel. Oh also he was right what he meant was the effect the benedryl made was euphoric, weed is euphoric, makes ya feel warm, and good. Only thing is, that it isnt made in some lab, with potiently harmful unwanted side effects.

[@debi623]

That was great he had me laughing

[@fondawilliam8371]

I guess take your medication or it is degenerative, is the moral.

[@ohh338]

oh my goodness :(

[@ahmeddip2886]

I have sameness

[@shellyann620]

Psychiatric drugs are sent my the devil himself!! Stay away from these drugs!!!

[@ArcadiyIvanov]

+Shelly Ann Yes, and aliens. Only a foil hat will save you.

[@shellyann620]

Keep drinking the cool aid www.madinamerica.com/2016/05/the-fda-is-hiding-reports-linking-psych-drugs-to-homicides/?

[@ohh338]

you are right

[@deatherman1027]

Shelly Ann no water, Kool-aid has sugar

[@JESUSSavedMefromDeath]

I hope not but a psychosis is like, (and probably is), an attack. You cant sleep. What little sleep you get are nightmares from Hell. Devils everywhere. Its like having your mind in the spirit world. Delusions of thinking we are already in Hell. By GODS Grace, he allowed me to live this long. The torment is severe in an unhealthy mind. Unfortunately too many people with mental illnesses commit suicide. JESUS said sick people need a doctor. I pray in JESUS' name that they find something that works with slim to none side effects.

[@kristykellytube]

I have had dystonic reactions to: reglan, compazine, inapseine and haldol. Is Lyrica a safe drug for someone susceptible to these reactions? Btw..Dr. James Fick did my brain surgery several yrs ago at MCG. Amazing staff and hospital!

[@OnlyZunkin]

kristykellytube Probably not. Lyrica is also a nueroleptic just like all the medications you just listed. Be warned that dystonic reactions can become permanent from taking these drugs.