Reversible Dysphagia Associated With Risperidone Presenting With a Choking Episode

Dysphagia has been associated with antipsychotic drug use. This case report describes the management of dysphagia in a psychiatric patient who presented to the emergency department from a psychiatric facility after choking on a hot dog. The patient was on risperidone 4 mg, initiated a month prior to treat acute psychosis. Foreign body removal from the distal trachea was performed by bronchoscopy, followed by a swallow evaluation by the speech and swallow team. The patient exhibited severe oropharyngeal dysphagia, leading to aspiration pneumonia and subsequent enteral feeding through a nasojejunal tube. Changes in medication from risperidone to aripiprazole, along with a short course of benztropine and dietary modifications, were implemented, with gradual improvement in swallowing function observed during the hospital stay. The patient's complex medical and psychiatric history contributed to a prolonged hospital stay.