A 40-year-old male presents with poor adherence to Haloperodol 10mg BD. He complains of unpleasant motor symptoms. His wife repos that he is restless all the time. When asked about it, the patient repos having an ‘urge to move’ constantly. Which of the following explains the symptoms?

**Core Concept**
Haloperidol, a typical antipsychotic, is a dopamine D2 receptor antagonist. It can cause extrapyramidal side effects (EPS) due to its blockade of dopamine receptors in the nigrostriatal pathway, leading to an imbalance in motor control.

**Why the Correct Answer is Right**
The patient's symptoms of restlessness, urge to move constantly, and poor adherence to haloperidol due to unpleasant motor symptoms are classic signs of akathisia. Akathisia is a type of EPS caused by the blockade of dopamine D2 receptors in the striatum, leading to an increase in the activity of the nigrostriatal pathway. This results in an excessive urge to move, which is often accompanied by restlessness, fidgeting, and agitation. The patient's symptoms are likely due to the blockade of dopamine receptors by haloperidol.

**Why Each Wrong Option is Incorrect**
**Option A:** is not relevant to the patient's symptoms.
**Option B:** is incorrect because it does not specifically address the patient's symptoms of restlessness and urge to move.
**Option C:** is incorrect because it does not accurately describe the patient's symptoms or the underlying mechanism of EPS.

**Clinical Pearl / High-Yield Fact**
Akathisia is a common side effect of antipsychotics, especially typical antipsychotics like haloperidol. It can be managed with beta-blockers, such as propranolol, or by switching to an atypical antipsychotic.

**Correct Answer: C. Extrapyramidal side effects due to blockade of dopamine D2 receptors in the nigrostriatal pathway.**

✓ Correct Answer: C. Akathesia