Nokea
An adolescent male is newly diagnosed with schizophrenia. Which of the following antipsychotic agents may have the best chance to improve his apathy and blunted affect?
Correct Answer: D
Rationale: Risperidone, a second-generation antipsychotic, blocks D2 and 5HT2 receptors, improving positive symptoms (hallucinations) and, to some extent, negative symptoms like apathy and blunted affect, common in schizophrenia's prodrome. First-generation agents—chlorpromazine, fluphenazine, haloperidol—target D2 receptors, effectively reducing positive symptoms but often worsening negative symptoms via dopamine blockade in the prefrontal cortex. Thioridazine, also first-generation, has similar limitations. Risperidone's serotonin antagonism may enhance prefrontal dopamine release, offering a modest edge in addressing negative symptoms, supported by studies, making it preferable for this adolescent's presentation.