All of the following are first generation antipsychotics except,
Explanation & Rationale
A. Clozapine (Clozaril) is a second-generation (atypical) antipsychotic known for its strong dopamine (D2) and serotonin (5-HT2A) blockade. It is primarily used for treatment-resistant schizophrenia but has a high risk of agranulocytosis, metabolic syndrome, and sedation, requiring regular blood monitoring. B. Haloperidol (Haldol) is a first-generation (typical) antipsychotic that strongly blocks dopamine (D2) receptors, leading to a high risk of extrapyramidal symptoms (EPS) such as dystonia, tardive dyskinesia, and akathisia. It is commonly used for acute psychosis and agitation. C. Fluphenazine (Prolixin is a first-generation antipsychotic that also strongly antagonizes D2 receptors, making it effective for chronic schizophrenia but highly associated with EPS. It is available in long-acting injectable (LAI) form for maintenance therapy. D. Chlorpromazine (Thorazine) is a first-generation, low-potency antipsychotic with strong sedative, anticholinergic, and hypotensive effects. While it has a lower risk of EPS compared to high-potency FGAs like haloperidol, it causes more sedation, orthostatic hypotension, and weight gain due to histamine and muscarinic receptor blockade.