Psychopharmacology: acute dystonia versus parkinsonism 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 · Psychopharmacology: acute dystonia versus parkinsonism treatment

Sample item

Drug-induced parkinsonism with tremor and rigidity develops in a patient on a high-potency antipsychotic. Which agent is used for symptomatic relief?

ALevodopaBTrihexyphenidylCHaloperidolDBromocriptine in high dose

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

The answer and the reasoning

B. Trihexyphenidyl

Antipsychotic parkinsonism arises from D2 blockade in the nigrostriatal tract, and anticholinergics such as trihexyphenidyl or benztropine restore the dopamine-acetylcholine balance. Dose reduction or a switch to an atypical agent is also done, and levodopa can worsen psychosis.

Option by option

A. Levodopa
Levodopa may aggravate psychosis.
B. Trihexyphenidyl (correct)
Correct. Anticholinergics treat drug-induced parkinsonism.
C. Haloperidol
Haloperidol would worsen the condition.
D. Bromocriptine in high dose
Dopamine agonists can worsen psychosis.

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 B, Trihexyphenidyl. Antipsychotic parkinsonism arises from D2 blockade in the nigrostriatal tract, and anticholinergics such as trihexyphenidyl or benztropine restore the dopamine-acetylcholine balance.

Why is "Levodopa" not the answer?

Levodopa may aggravate psychosis.

Why is "Haloperidol" not the answer?

Haloperidol would worsen the condition.

Why is "Bromocriptine in high dose" not the answer?

Dopamine agonists can worsen psychosis.

What concept does this question test?

It tests Psychopharmacology: acute dystonia versus parkinsonism treatment in Psychiatry. Dose reduction or a switch to an atypical agent is also done, and levodopa can worsen psychosis.

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: acute dystonia versus parkinsonism 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.