Which of the following has the highest risk for EPS?

A. Haloperidol (Haldol) is a first-generation (typical) antipsychotic that primarily blocks dopamine (D2) receptors. It is associated with a higher risk of extrapyramidal side effects (EPS), including dystonia, akathisia, and tardive dyskinesia, compared to second-generation antipsychotics.

B. Ziprasidone (Geodon) is a second-generation (atypical) antipsychotic that blocks both dopamine (D2) and serotonin (5-HT2A) receptors. It has a lower risk of EPS but can cause QT prolongation, requiring ECG monitoring in patients with cardiac conditions.

C. Risperidone (Risperdal) is a second-generation antipsychotic with dopamine and serotonin antagonism. It is effective for schizophrenia, bipolar disorder, and irritability in autism but has a higher likelihood of prolactin elevation and EPS at higher doses.

D. Olanzapine (Zyprexa) is a second-generation antipsychotic known for its high risk of metabolic side effects, including weight gain, diabetes, and dyslipidemia. It has a lower risk of EPS compared to first-generation antipsychotics.

A. Lack of motivation. Avolition, not alogia, refers to a severe lack of motivation to initiate and sustain goal-directed activities. It is a common negative symptom of schizophrenia, leading to difficulties in completing tasks such as hygiene, work, or social activities.

B. No empathy. Lack of empathy is more commonly associated with antisocial personality disorder (ASPD) or narcissistic personality disorder (NPD) rather than schizophrenia. Individuals with schizophrenia may struggle with social interactions, but this is due to cognitive deficits rather than a lack of concern for others.

C. Reduction in quantity of words spoken. Alogia refers to poverty of speech, characterized by diminished verbal output and difficulty generating spontaneous speech. It is a negative symptom of schizophrenia, often presenting as brief, empty responses or difficulty engaging in conversation.

D. Inability to experience pleasure. Anhedonia refers to the inability to feel pleasure in activities that were once enjoyable. It is another negative symptom of schizophrenia and is also seen in major depressive disorder and other mood disorders.