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Prochlorperazine (PCZ; Compazine) is widely used in the ED and is associated with extrapyramidal side effects, especially akathisia and dystonia. Akathisia, sometimes referred to as "dysphoria," may occur within minutes of dosing or, less commonly, at a delay of up to 48 hours. These investigators prospectively studied the incidence of PCZ-induced akathisia in the ED.
A convenience sample of 100 patients age 16 to 65 with severe headache or vomiting were given 10 mg of PCZ IV and evaluated for akathisia after 1 and 48 hours. No other medications were given for at least 1 hour. Forty patients who received nonakathisic IV medications served as controls. Akathisia developed within 1 hour in 44 patients (44%) in the PCZ group and in no controls.…