MEDizzy - A 51-year-old woman, a resident in a psychiatric unit,

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NEUROLEPTIC DRUGS

A 51-year-old woman, a resident in a psychiatric unit, complained about feeling dizzy to the point of fainting upon standing up rapidly. The patient was hospitalized because over the past 3 months she had become increasingly agitated and afraid. She was convinced that people near her house were devils, plotting about stealing her money and cutting her throat. The patient started a psychotropic medication 2 weeks previously. Which of the following drugs most likely caused the patient’s symptoms?

ExplanationThe correct answer is B. The symptoms of the patient indicate that she was most likely suffering from postural hypotension. Atypical neuroleptics (with the exception of clozapine) have become first-line agents for the treatment of an acute psychotic episode, mainly because of few or no acutely occurring extrapyramidal side effects. Most atypical neuroleptics have significant blocking activity on α1 receptors, so postural hypotension is a frequent adverse effect, as in this case. A Haloperidol is used to treat an acute psychotic episode, but postural hypotension is a rare adverse effect, as it has minimal blocking activity on α1 receptors. C, D These drugs are devoid of antipsychotic properties.