Dystonic Phenergan

What? You never heard of it? Well I became intimately familiar with dystonic Phenergan during a recent visit to the emergency room.

Okay, so I’m in the emergency room for pretty severe pain in my abdomen which turned out to be diverticulitis, but we don’t have to get into that end of it

They give me morphine for the pain right away and (I don’t know this at the time) they add the Phenergan to keep me from feeling nauseous which morphine has a tendancy to do. Now at first I’m pretty happy because the pain goes away almost immediately, but then I begin to feel, and it’s hard to describe the sensation, maybe, overdosed. And I say it to my husband.

For the next few hours ( it was New Year’s Eve – yeah, New Year’s Eve, so?) I feel a grogginess but not enough to want to stop the morphine. I figure I’m in no danger surrounded by all these doctors and nurses, you know. I’m not driving or doing a surgical procedure, right?

But then I begin to fade and feel weak, and I tell my husband, “Get somebody, Vin, I’m feeling strange.” I begin to hyperventilate and when the nurse doesn’t come, I call, “Vin, hurry” in a raspy, strangled voice.

And they do hurry, asking “Mary, what’s wrong? Mary? Looks like she’s having a panic attack.” “Mary, there’s nothing to be anxious about, you’re in good hands.” But the nurse says, “Look, her arms are dropping, she can’t hold them up. “

By this time tears are dripping out of the corners of my eyes, I can’t speak above a whisper, my breathe is coming in short gasps and I can’t maintain focus. I don’t know who thought of the diagnosis first, the doctor or the nurse, but one of them says, “Wait, I know exactly what this is…” And it seems she sends for something, and another nurse approaches the other side of the bed and gives me an injection either directly into my body (I didn’t feel anything) or the intravenous.

I whisper to my husband I’m thirsty and he has to lift my head to take a drink. I couldn’t lift it myself. But I come back quickly, maybe five minutes, and I know I’m coming out of it. In ten minutes time I’m back to normal.

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I wanted to know what happened. The doctor said I have the information for you right away. What antidote had they given me? “Benadryl,” said the nurse. Benadryl! I had had an allergic reaction to a drug.

Here’s the information they gave me:

You are having a muscular reaction to a drug you have taken. This can cause tightening or stiffening of the muscles of the eyes, tongue, jaw, neck, back arms and legs. It also causes a feeling of sadness and despair. Due to the severity of the spasm and the feeling that you cannot move normally, you may feel a lot of anxiety. If untreated, this reaction would last until the drug is eliminated from your body and could take up to three days. However, you have been treated with an antidote, to reverse this reaction. Benadryl (diphenhydramine), Cogentin or Artane are often used for this purpose.

Most dystonic reactions are due to a class of drugs called phenothiazines. This includes anti-nausea drugs such as Compazine, Phenergan, Tigan, Inaspine and others. If you have reacted to one drug in this class, any drug in this class will probably cause the same reaction. Unless specifically advised by your doctor who knows about this reaction, do not take the offending drug ever again.

Was I scared? You bet. Do I have any complaints about response of the emergency room personnel? Absolutely not. As a matter of fact I’m grateful for their speedy reaction and realization of what was happening to me.

Have I learned anything from my experience (don’t they always ask that?)? Oh yes, of course, avoid Phenergan and such drugs forever and this is probably something I ought to keep in mind in the future: Never, ever go to the emergency room on New Year’s Eve.

maryt