{"id":9081,"date":"2026-01-14T00:02:24","date_gmt":"2026-01-14T08:02:24","guid":{"rendered":"https:\/\/www.osmosis.org\/blog\/?p=9081"},"modified":"2025-12-16T16:05:17","modified_gmt":"2025-12-17T00:05:17","slug":"usmle-step-1-question-of-the-day-antipsychotic-medication","status":"publish","type":"post","link":"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-antipsychotic-medication","title":{"rendered":"USMLE\u00ae Step 1 Question of the Day:\u00a0Antipsychotic medication"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_80 ez-toc-wrap-center counter-hierarchy ez-toc-counter ez-toc-custom ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">In This Article<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-antipsychotic-medication\/#The_correct_answer_to_todays_USMLE%C2%AE_Step_1_Question_is%E2%80%A6\" >The correct answer to today\u2019s USMLE\u00ae Step 1 Question is\u2026<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-antipsychotic-medication\/#Incorrect_Answer_Explanations\" >Incorrect Answer Explanations<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-antipsychotic-medication\/#Main_Explanation\" >Main Explanation<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-antipsychotic-medication\/#Major_Takeaway\" >Major Takeaway&nbsp;<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-antipsychotic-medication\/#Want_to_learn_more_about_this_topic\" >Want to learn more about this topic?<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-antipsychotic-medication\/#References\" >References<\/a><\/li><\/ul><\/nav><\/div>\n\n<p class=\"wp-block-paragraph\"><em>Today\u2019s USMLE\u00ae Step 1 question of the day features a 20-year-old man with schizophrenia who develops involuntary lip, tongue, and limb movements after starting an antipsychotic. Which medication is most likely responsible\u2014and what does its name reveal about atypical antipsychotics?<\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A 20-year-old man presents to the clinic because he has <strong>heard voices for the past nine months.<\/strong>\u00a0According to his parents, the patient has been acting strangely over the past year. He dropped out of school and\u00a0broke\u00a0contact with his friends. He has been increasingly obsessed with government <strong>conspiracies <\/strong>and believes the government has placed trackers in his body. The patient is diagnosed with <strong>schizophrenia <\/strong>and prescribed an <strong>antipsychotic medication<\/strong>. He\u00a0presents\u00a0to the clinic again three months later after having developed <strong>involuntary <\/strong>and bothersome <strong>movements <\/strong>of the lips and tongue and\u00a0<strong>writhing\u00a0movements<\/strong> of the extremities. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Which of the following medications has the highest risk of causing this side effect?\u00a0<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>A. Risperidone<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>B. Thioridazine<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>C. Clozapine<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>D. Aripiprazole<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>E. Paliperidone<\/strong><\/p>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\"><em>Scroll down for the correct answer!<\/em><\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"Osmosis.org at the University College London, UK\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/DIp3u0oTLo4?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"The_correct_answer_to_todays_USMLE%C2%AE_Step_1_Question_is%E2%80%A6\"><\/span>The correct answer to today\u2019s USMLE\u00ae Step 1 Question is\u2026<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>B. Thioridazine<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Correct:<\/strong> See Main Explanation.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Incorrect_Answer_Explanations\"><\/span>Incorrect Answer Explanations<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>A. Risperidone<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect: <\/strong>Risperidone is an <strong>atypical antipsychotic<\/strong> with a lower risk of <strong>tardive dyskinesia <\/strong>when compared to first-generation antipsychotics. Risperidone is associated with symptoms of <strong>hyperprolactinemia<\/strong>, such as <strong>amenorrhea, galactorrhea, <\/strong>and <strong>gynecomastia<\/strong>. Atypical antipsychotics usually end in \u201c-apine\u201d or \u201c-idone\u201d.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>C. Clozapine<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:<\/strong> Clozapine is an atypical antipsychotic with a lower risk of tardive dyskinesia when compared to <strong>first-generation antipsychotics<\/strong>. <strong>Side effects<\/strong> associated with clozapine include <strong>metabolic syndrome, agranulocytosis, <\/strong>and <strong>increased seizure risk.<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>D. Aripiprazole<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:<\/strong> Aripiprazole is an atypical antipsychotic with a lower risk of tardive dyskinesia when compared to first-generation antipsychotics. Atypical antipsychotics usually end in \u201c-apine\u201d or \u201c-idone\u201d.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>E. Paliperidone<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:<\/strong> Paliperidone is an atypical antipsychotic with a lower risk of tardive dyskinesia. Atypical antipsychotics usually end in \u201c-apine\u201d or \u201c-idone\u201d.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Main_Explanation\"><\/span>Main Explanation<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">This patient&nbsp;presents with&nbsp;symptoms of<strong>&nbsp;tardive dyskinesia<\/strong>, which are more likely to occur in patients taking first-generation antipsychotics such as&nbsp;<strong>thioridazine<\/strong>.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Antipsychotics are used to treat schizophrenia and other psychotic disorders. First-generation antipsychotics, also known as&nbsp;<strong>typical antipsychotics<\/strong>,&nbsp;<strong>block dopamine D2 receptors&nbsp;<\/strong>in the brain. These include haloperidol, pimozide, trifluoperazine, fluphenazine, thioridazine, and chlorpromazine. They are associated with several side effects, including hyperprolactinemia, metabolic syndrome, QT prolongation, neuroleptic malignant syndrome, and<strong>&nbsp;extrapyramidal symptoms&nbsp;<\/strong>(e.g., acute dystonia, akathisia, parkinsonism, tardive dyskinesia). Typical antipsychotics often end in the suffix \u201c-azine\u201d.&nbsp;&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Second-generation antipsychotics, also known as atypical antipsychotics, work via\u00a0<strong>inhibition of dopamine D2 receptors in the mesolimbic pathway\u00a0<\/strong>and\u00a0<strong>inhibition of serotonin 5-HT2A receptors in the\u00a0mesocortical\u00a0pathway.<\/strong> Standard atypical antipsychotics include clozapine, olanzapine, quetiapine, paliperidone, risperidone, lurasidone, ziprasidone, and aripiprazole. Per naming convention, <strong>atypical antipsychotics<\/strong> usually\u00a0<strong>end in the suffixes \u201c-apine\u201d or \u201c-idone\u201d.<\/strong>\u00a0Notably, atypical antipsychotics have a lower risk of extrapyramidal symptoms than\u00a0the typical\u00a0antipsychotics.\u00a0<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Major_Takeaway\"><\/span>Major Takeaway&nbsp;<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Atypical antipsychotics have a lower risk of causing tardive dyskinesia than typical antipsychotics. Per naming convention, atypical antipsychotics usually end in the suffixes \u201c-apine\u201d or \u201c-idone,\u201d whereas typical antipsychotics often end in \u201c-azine\u201d.\u00a0\u00a0<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Want_to_learn_more_about_this_topic\"><\/span>Want to learn more about this topic?<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Watch this Osmosis video: <a href=\"https:\/\/www.osmosis.org\/learn\/Class_I_antiarrhythmics:_Sodium_channel_blockers\">Typical antipsychotic<\/a><a href=\"https:\/\/www.osmosis.org\/learn\/Typical_antipsychotics\">s<\/a><\/strong><\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"References\"><\/span>References<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Trevor, A.J., Katzung, B.G.,\u00a0Kruidering-Hall, M. (2015)\u00a0Katzung\u00a0&amp; Trevor&#8217;s pharmacology: Examination &amp; board review (13th ed.). New York, NY: McGraw-Hill. ISBN: 978-0071826358.\u00a0<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image size-large\"><a href=\"https:\/\/www.osmosis.org\/plans\"><img loading=\"lazy\" decoding=\"async\" width=\"700\" height=\"250\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/10\/Blog_Display_Ads_MOBILE3_2023.png?w=700\" alt=\"\" class=\"wp-image-4729\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/10\/Blog_Display_Ads_MOBILE3_2023.png 700w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/10\/Blog_Display_Ads_MOBILE3_2023.png?resize=300,107 300w\" sizes=\"auto, (max-width: 700px) 100vw, 700px\" \/><\/a><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\"><em>Want more <strong>USMLE\u00ae Step 1<\/strong> practice questions? Try <strong>Osmosis from Elsevier<\/strong> today! Access your&nbsp;<em><a href=\"https:\/\/www.osmosis.org\/plans\" target=\"_blank\" rel=\"noreferrer noopener\"><strong>free trial<\/strong><\/a><\/em>&nbsp;and discover why millions of current and future <strong>clinicians <\/strong>and <strong>caregivers <\/strong>love <strong>learning with us<\/strong>.<\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n","protected":false},"excerpt":{"rendered":"<p>A patient with schizophrenia develops involuntary movements after antipsychotic treatment. Learn which medication carries the highest risk and how atypicals are named.<\/p>\n","protected":false},"author":204,"featured_media":9084,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_post_was_ever_published":false},"categories":[27,20,16,1366,1369,44],"tags":[2513,2514,2509,2506,2512,2510,2516,2308,955,2508,2515,1139,2507,2511,2505],"class_list":["post-9081","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medicine","category-exam-prep","category-do","category-questions","category-step-1-questions","category-step-1","tag-antipsychotic-naming","tag-antipsychotic-risks","tag-antipsychotic-side-effects","tag-atypical-antipsychotics","tag-dopamine-blockers","tag-extrapyramidal-symptoms","tag-mental-health-drugs","tag-movement-disorders","tag-neuroleptic-malignant-syndrome","tag-psychiatric-medications","tag-psychiatric-pharmacology","tag-schizophrenia","tag-tardive-dyskinesia","tag-thioridazine","tag-typical-antipsychotics"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.6 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>USMLE\u00ae Step 1 Question of the Day:\u00a0Antipsychotic medication - Osmosis Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-antipsychotic-medication\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"USMLE\u00ae Step 1 Question of the Day:\u00a0Antipsychotic medication - Osmosis Blog\" \/>\n<meta property=\"og:description\" content=\"A patient with schizophrenia develops involuntary movements after antipsychotic treatment. 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