Psychopharmacology: managing risperidone hyperprolactinaemia: 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.

Try it

Psychiatry · Psychopharmacology: managing risperidone hyperprolactinaemia

Sample item

A woman with schizophrenia stable on risperidone has galactorrhoea, amenorrhoea and a raised prolactin. Her psychosis is controlled. Which change is most suitable?

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

The answer and the reasoning

B. Switch to aripiprazole

Aripiprazole is a D2 partial agonist that lowers prolactin and is a common switch when hyperprolactinaemia is troublesome. Haloperidol and amisulpride also raise prolactin markedly, and domperidone is a prolactin-raising dopamine blocker.

Option by option

  • A. Switch to amisulpride

    Amisulpride is among the antipsychotics most likely to raise prolactin.

  • B. Switch to aripiprazole (correct)

    Correct. Partial agonism at D2 spares prolactin regulation.

  • C. Add domperidone

    Domperidone blocks D2 receptors and itself raises prolactin.

  • D. Switch to haloperidol

    Haloperidol is a potent D2 blocker that raises prolactin.

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.

More Psychiatry questions

Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is B, Switch to aripiprazole. Aripiprazole is a D2 partial agonist that lowers prolactin and is a common switch when hyperprolactinaemia is troublesome.

Why is "Switch to amisulpride" not the answer?

Amisulpride is among the antipsychotics most likely to raise prolactin.

Why is "Add domperidone" not the answer?

Domperidone blocks D2 receptors and itself raises prolactin.

Why is "Switch to haloperidol" not the answer?

Haloperidol is a potent D2 blocker that raises prolactin.

What concept does this question test?

It tests Psychopharmacology: managing risperidone hyperprolactinaemia in Psychiatry. Haloperidol and amisulpride also raise prolactin markedly, and domperidone is a prolactin-raising dopamine blocker.

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: managing risperidone hyperprolactinaemia?

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.