A 53-y-o patient presented approximately 2 h after taking her first dose of
nefazadone. Chief complaint was lip smacking with hand and arm gesturing.
The patient also took 25 mg meclizine which she had used before with no adv
erse effects. Diphenhydramine followed by benztropine led to resolution of
symptoms within 1 h. Patient subsequently used meclizine with no untoward r
eactions. Nefazadone should be added to the list of agents that cause acute
dystonic reactions.