Antidepressant drug that can cause neuroleptic malignant syndrome and tardive dyskinesia is: March 2009
**Core Concept:** Neuroleptic malignant syndrome (NMS) and tardive dyskinesia are two serious adverse effects of certain antipsychotic medications, also known as neuroleptic drugs. NMS is a potentially life-threatening condition characterized by fever, muscle rigidity, autonomic instability, and altered mental status, while tardive dyskinesia is a long-term complication of neuroleptic medication characterized by involuntary, repetitive, and pruritic movements of the face, tongue, and limbs.
**Why the Correct Answer is Right:** The correct answer, D, refers to the neuroleptic drug that can cause both NMS and tardive dyskinesia. It is essential to understand that neuroleptic drugs are a class of medications primarily designed to treat psychotic disorders, such as schizophrenia and bipolar disorder. The correct answer, clozapine, is a second-generation antipsychotic medication (SGAs) that is highly effective in treating schizophrenia and has been associated with a higher risk of both NMS and tardive dyskinesia compared to other neuroleptic drugs.
**Why Each Wrong Option is Incorrect:**
A. Haloperidol: This is a first-generation antipsychotic (FGA) medication and has a lower risk of causing NMS and tardive dyskinesia compared to clozapine.
B. Risperidone: Another second-generation antipsychotic medication, risperidone is also associated with a lower risk of NMS and tardive dyskinesia compared to clozapine.
C. Olanzapine: Olanzapine is another second-generation antipsychotic medication with a lower risk of NMS and tardive dyskinesia compared to clozapine.
**Clinical Pearl:** When prescribing antipsychotic medications, especially clozapine, it is crucial to closely monitor patients for signs of NMS and tardive dyskinesia due to their increased risk. Additionally, considering the patient's risk factors (e.g., age, pre-existing neurological disorders, and concomitant medications) and choosing a medication with a lower risk profile can help prevent these severe side effects.