Mr. D., a 28-year-old man with schizophrenia, presents to th…

Questions

Mr. D., а 28-yeаr-оld mаn with schizоphrenia, presents tо the outpatient clinic after being discharged from an inpatient unit where he was treated with haloperidol 10 mg daily. He reports that his hallucinations and delusions have improved significantly, but he now feels “stiff,” has a “mask-like face,” and finds it hard to move his neck. On exam, he exhibits bradykinesia, rigidity, and mild resting tremor, consistent with drug-induced parkinsonism.He denies fever, confusion, or autonomic instability. Labs are normal.You decide to transition him to an antipsychotic with a lower risk of extrapyramidal side effects (EPS) while maintaining strong efficacy for both positive and negative symptoms.Which of the following antipsychotics would be most appropriate to initiate, and what pharmacologic mechanism explains its lower EPS risk?

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