Acute dystonia following occupational inhalation of risperidone powder in a pharmaceutical trainee chemist

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Abstract Risperidone is an atypical antipsychotic whose occupational hazards, particularly via inhalation, are under-recognized. We report the case of a 22-year-old male trainee chemist in a pharmaceutical company who developed acute dystonia after unintentional inhalation of risperidone powder while working in a dryer room without adequate respiratory protection. Symptoms, including orofacial deviation, jaw clenching, torticollis, hand tremors, giddiness, tachycardia, and hypertension, began approximately 1 h postexposure. The patient was managed supportively, and his symptoms resolved completely over 48 h. This case highlights a significant occupational health risk in pharmaceutical manufacturing. The pulmonary absorption of powdered drugs can bypass first-pass metabolism, leading to rapid systemic toxicity. The absence of previous similar reports in the literature suggests substantial underreporting. This incident underscores the critical need for enforcing strict occupational safety measures, including the use of appropriate personal protective equipment and engineering controls, in units handling potent powdered active pharmaceutical ingredients.