Haloperidol causes rare case of tongue angioedema: Report
Man developed swelling minutes after taking antipsychotic
Haloperidol, an antipsychotic medication commonly used to treat schizophrenia and severe agitation, was behind a rare case of angioedema of the tongue — a sudden, potentially life-threatening swelling — for a man in Tunisia, as detailed a case report.
Although angioedema can occur as an allergic reaction or as a side effect to certain medications, it is not typically associated with haloperidol, which is marketed under the brand name Haldol.
The report, “Unexpected Adverse Effect of Haloperidol: Acute Tongue Angioedema in a Schizophrenic Patient — Case Report and Review,” was published in Case Reports in Psychiatry. There have been few other reports of angioedema caused by haloperidol.
Angioedema occurs when fluid leaks from blood vessels into nearby tissues, causing swelling beneath the skin or mucous membranes. When it involves the tongue or throat, it can block the airways and quickly become a medical emergency. There are many possible causes of angioedema, including medications.
A sudden, unexpected allergic reaction
The 54-year-old man described in the report had been taking haloperidol for schizophrenia for about a year, with no history of allergies. One day, a few minutes after taking two pills, “a prompt and rapidly increasing tongue swelling occurred, along with pain and discomfort from jaw clenching,” the researchers wrote.
“The patient reported difficulties with speech and feeding without signs of dyspnea [difficulty breathing],” they wrote.
Because swelling in such cases can progress rapidly, doctors must be prepared to secure a patient’s airways. This may involve inserting a breathing tube or, in extreme cases, surgery. The man was admitted to the hospital so his breathing could be closely monitored.
“The established cause for this condition was an allergic reaction to haloperidol,” the researchers wrote.
Doctors immediately stopped haloperidol, and the swelling gradually went away on its own. No breathing support was needed, and the patient recovered fully. His tongue returned to its normal size, and there were no lasting effects.
“The rapid onset of tongue swelling in our patient necessitated immediate recognition and monitoring due to the risk of acute upper airway obstruction and respiratory compromise,” the researchers wrote. “This case underscores the importance of vigilance and prompt diagnosis in managing such rare adverse reactions associated with haloperidol.”
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