Which of the following has the highest risk for EPS?
Explanation & Rationale
A. Aripiprazole (Abilify) is a second-generation (atypical) antipsychotic with a lower risk of extrapyramidal symptoms (EPS) due to its partial dopamine agonist mechanism. It has a lower incidence of tardive dyskinesia and dystonia compared to typical antipsychotics. B. Clozapine (Clozaril) has the lowest risk of EPS among antipsychotics because it weakly blocks D2 receptors and primarily targets serotonin (5-HT2A) receptors. However, it carries a high risk of agranulocytosis, sedation, and metabolic syndrome. C. Lurasidone (Latuda) is a second-generation antipsychotic with a moderate risk of EPS, particularly akathisia (restlessness). However, it has a lower risk than first-generation (typical) antipsychotics like haloperidol. D. Haloperidol (Haldol) is a first-generation (typical) antipsychotic with a high risk of EPS due to its strong dopamine (D2) receptor blockade. It is associated with dystonia, akathisia, parkinsonism, and tardive dyskinesia, making it the antipsychotic with the highest EPS risk in this list.