A 42-year-old man is diagnosed with a psychotic depression and is started on imipramine and perphenazine. When he develops dystonia, he is begun on benztropine 2 mg/day. One week later, his wife reports that the patient has become unusually forgetful and seems disoriented at night. On physical examination, the man appears slightly flushed, his skin and palms are dry, and he is tachycardic. He is oriented to name and place only. He showed none of these symptoms during his last appointment. Which of the following is the most likely diagnosis?
a) Anticholinergic syndrome
b) Neuroleptic malignant syndrome
c) Extrapyramidal side effect
d) Akathisia
