Antipsychotic drug with least extra pyramidal symptoms –
**Core Concept**
The question is testing the understanding of the pharmacological differences between various antipsychotic medications, specifically their propensity to cause extrapyramidal symptoms (EPS). EPS are a group of movement disorders associated with the blockade of dopamine D2 receptors in the striatum.
**Why the Correct Answer is Right**
The correct answer is **Clozapine**. Clozapine is an atypical antipsychotic that has a lower affinity for dopamine D2 receptors and a higher affinity for serotonin 5-HT2A receptors. This unique pharmacological profile reduces the risk of EPS and makes it an effective option for patients who have not responded to other antipsychotics. The blockade of serotonin receptors also contributes to its efficacy in treating negative symptoms of schizophrenia.
**Why Each Wrong Option is Incorrect**
**Option A:** Haloperidol is a typical antipsychotic that has a high affinity for dopamine D2 receptors, making it more likely to cause EPS. Haloperidol is a first-generation antipsychotic that is often associated with a higher risk of EPS.
**Option B:** Risperidone is an atypical antipsychotic that has a lower risk of EPS compared to typical antipsychotics. However, it still has a higher affinity for dopamine D2 receptors than Clozapine, making it more likely to cause EPS than Clozapine.
**Option C:** Olanzapine is another atypical antipsychotic that has a lower risk of EPS. However, it has a higher affinity for dopamine D2 receptors than Clozapine, making it more likely to cause EPS than Clozapine.
**Clinical Pearl / High-Yield Fact**
Clozapine is often considered a "last-line" antipsychotic due to its potential side effects, including agranulocytosis and seizures. However, its unique pharmacological profile makes it an effective option for patients who have not responded to other antipsychotics.
**Correct Answer:** C. Olanzapine