Antipsychotics: akathisia: 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 · Antipsychotics: akathisia

Sample item

Three days after starting haloperidol, a patient is unable to sit still, paces the ward and says he feels a compelling inner restlessness. The drug most useful for treatment is:

APropranololBLithiumCDantroleneDTrihexyphenidyl alone in high dose

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

The answer and the reasoning

A. Propranolol

Akathisia is subjective and motor restlessness after dopamine antagonists, and first-line treatments are dose reduction and propranolol (a beta blocker). Benzodiazepines and mirtazapine are alternatives.

Option by option

A. Propranolol (correct)
Correct. Propranolol is the preferred drug for akathisia.
B. Lithium
Lithium has no role in treating akathisia.
C. Dantrolene
Dantrolene is used in NMS and malignant hyperthermia.
D. Trihexyphenidyl alone in high dose
Anticholinergics are less effective for akathisia than for parkinsonism.

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.

Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is A, Propranolol. Akathisia is subjective and motor restlessness after dopamine antagonists, and first-line treatments are dose reduction and propranolol (a beta blocker).

Why is "Lithium" not the answer?

Lithium has no role in treating akathisia.

Why is "Dantrolene" not the answer?

Dantrolene is used in NMS and malignant hyperthermia.

Why is "Trihexyphenidyl alone in high dose" not the answer?

Anticholinergics are less effective for akathisia than for parkinsonism.

What concept does this question test?

It tests Antipsychotics: akathisia in Psychiatry. Benzodiazepines and mirtazapine are alternatives.

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 Antipsychotics: akathisia?

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.