Which statement about extrapyramidal symptoms risk is correct?

Which statement about extrapyramidal symptoms risk is correct?

• A. Both have equal risk
• B. Atypical antipsychotics have higher EPS risk
• C. Typical antipsychotics have higher EPS risk
• D. Neither has EPS risk

Answer: (C)

Extrapyramidal symptoms arise mainly from blocking dopamine D2 receptors in the brain’s motor pathways. Typical (first-generation) antipsychotics are strong D2 antagonists in the nigrostriatal pathway, which directly drives a higher chance of EPS such as acute dystonia, drug-induced parkinsonism, and akathisia. Atypical (second-generation) antipsychotics also block D2 but add serotonin-2A antagonism, which helps balance dopamine release and reduces the likelihood of these motor side effects. Because of this difference in action, the general pattern is that typical antipsychotics carry a higher risk of EPS than atypical ones. Some atypicals can still cause EPS at higher doses, but the overall risk is lower.

Extrapyramidal symptoms arise mainly from blocking dopamine D2 receptors in the brain’s motor pathways. Typical (first-generation) antipsychotics are strong D2 antagonists in the nigrostriatal pathway, which directly drives a higher chance of EPS such as acute dystonia, drug-induced parkinsonism, and akathisia. Atypical (second-generation) antipsychotics also block D2 but add serotonin-2A antagonism, which helps balance dopamine release and reduces the likelihood of these motor side effects. Because of this difference in action, the general pattern is that typical antipsychotics carry a higher risk of EPS than atypical ones. Some atypicals can still cause EPS at higher doses, but the overall risk is lower.