High-potency first-generation antipsychotics are most associated with which side effects?

High-potency first-generation antipsychotics are most associated with which side effects?

• A. Extrapyramidal Symptoms
• B. Sedation
• C. Weight Gain
• D. Orthostatic Hypotension

Answer: (A)

High-potency first-generation antipsychotics cause prominent extrapyramidal motor side effects because they strongly block D2 receptors in the nigrostriatal pathway, which governs movement. This direct dopamine blockade in motor circuits leads to types of EPS such as acute dystonia, parkinsonism, akathisia, and tardive dyskinesia, making EPS the most characteristic adverse effects of these drugs. Sedation tends to come from antihistamine effects and anticholinergic activity, which are more prominent with low-potency FGAs. Weight gain is more associated with metabolic effects seen with many second-generation antipsychotics, and orthostatic hypotension results from alpha-1 blockade, which is typically stronger with low-potency agents.

High-potency first-generation antipsychotics cause prominent extrapyramidal motor side effects because they strongly block D2 receptors in the nigrostriatal pathway, which governs movement. This direct dopamine blockade in motor circuits leads to types of EPS such as acute dystonia, parkinsonism, akathisia, and tardive dyskinesia, making EPS the most characteristic adverse effects of these drugs. Sedation tends to come from antihistamine effects and anticholinergic activity, which are more prominent with low-potency FGAs. Weight gain is more associated with metabolic effects seen with many second-generation antipsychotics, and orthostatic hypotension results from alpha-1 blockade, which is typically stronger with low-potency agents.