Psychopharmacology: antipsychotic choice in Parkinson disease: 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 · Psychopharmacology: antipsychotic choice in Parkinson disease

Sample item

A 72-year-old man with Parkinson disease develops troublesome visual hallucinations after dopaminergic treatment. If an antipsychotic is needed, which choice is least likely to worsen his motor symptoms?

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

The answer and the reasoning

D. Low-dose quetiapine

Antipsychotics with strong D2 blockade worsen parkinsonism. Low-dose quetiapine or clozapine, which have weak D2 binding, are preferred, and the dopaminergic regimen should also be reviewed. Haloperidol and risperidone should be avoided in Parkinson disease.

Option by option

  • A. Olanzapine

    Olanzapine has been shown to worsen motor function in Parkinson disease.

  • B. Risperidone

    Risperidone has strong D2 blockade and can worsen motor function.

  • C. Haloperidol

    Haloperidol is a potent D2 blocker and worsens parkinsonism.

  • D. Low-dose quetiapine (correct)

    Correct. Weak D2 blockade makes it the better-tolerated option.

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 D, Low-dose quetiapine. Antipsychotics with strong D2 blockade worsen parkinsonism.

Why is "Olanzapine" not the answer?

Olanzapine has been shown to worsen motor function in Parkinson disease.

Why is "Risperidone" not the answer?

Risperidone has strong D2 blockade and can worsen motor function.

Why is "Haloperidol" not the answer?

Haloperidol is a potent D2 blocker and worsens parkinsonism.

What concept does this question test?

It tests Psychopharmacology: antipsychotic choice in Parkinson disease in Psychiatry. Low-dose quetiapine or clozapine, which have weak D2 binding, are preferred, and the dopaminergic regimen should also be reviewed. Haloperidol and risperidone should be avoided in Parkinson disease.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Psychopharmacology: antipsychotic choice in Parkinson disease?

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.