Psychotic disorders: negative symptoms treatment: practice question

A Psychiatry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Psychiatry · Psychotic disorders: negative symptoms treatment

Sample item

Prominent negative symptoms with minimal positive symptoms in a stable patient on an antipsychotic. Which approach has the best support?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Rule out secondary causes such as depression, parkinsonism and sedation, then use psychosocial rehabilitation and consider switching to a drug with less D2 blockade

Secondary negative symptoms may arise from depression, neuroleptic-induced parkinsonism, sedation and social deprivation, so these must be excluded first. Psychosocial rehabilitation helps, and drugs with partial agonism such as aripiprazole or cariprazine, or clozapine, may be tried. Increasing a typical antipsychotic tends to worsen negative symptoms.

Option by option

  • A. Double the dose of haloperidol

    More haloperidol worsens parkinsonism and secondary negative symptoms.

  • B. Add a long-term benzodiazepine

    Long-term benzodiazepines risk dependence and add sedation.

  • C. Rule out secondary causes such as depression, parkinsonism and sedation, then use psychosocial rehabilitation and consider switching to a drug with less D2 blockade (correct)

    Correct. Treat secondary causes, use rehabilitation and consider a less D2-blocking agent.

  • D. Start an anticholinergic at high dose

    High-dose anticholinergics add cognitive side effects.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is C, Rule out secondary causes such as depression, parkinsonism and sedation, then use psychosocial rehabilitation and consider switching to a drug with less D2 blockade. Secondary negative symptoms may arise from depression, neuroleptic-induced parkinsonism, sedation and social deprivation, so these must be excluded first.

Why is "Double the dose of haloperidol" not the answer?

More haloperidol worsens parkinsonism and secondary negative symptoms.

Why is "Add a long-term benzodiazepine" not the answer?

Long-term benzodiazepines risk dependence and add sedation.

Why is "Start an anticholinergic at high dose" not the answer?

High-dose anticholinergics add cognitive side effects.

What concept does this question test?

It tests Psychotic disorders: negative symptoms treatment in Psychiatry. Psychosocial rehabilitation helps, and drugs with partial agonism such as aripiprazole or cariprazine, or clozapine, may be tried. Increasing a typical antipsychotic tends to worsen negative symptoms.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Psychotic disorders: negative symptoms treatment?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.