Question:
Which of the following antipsychotics is most associated with increased prolactin secretion?
Which of the following antipsychotics is most associated with increased prolactin secretion?
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The most potent D2 blocker among the atypicals raises prolactin the most.
Updated On: Jun 24, 2026
- Olanzapine
- Ziprasidone
- Clozapine
- Risperidone
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The Correct Option is D
Solution and Explanation
Step 1: Recall the prolactin link. Dopamine \(D_2\) blockade in the tuberoinfundibular pathway removes dopamine's inhibition of prolactin, so prolactin rises.
Step 2: Compare the drugs. Risperidone is a potent \(D_2\) blocker (more potent than clozapine) with combined 5-HT2a and \(D_2\) antagonism, and it causes a marked, dose-related rise in prolactin.
Step 3: Conclude. Among the choices, risperidone produces the greatest hyperprolactinemia, so option D is correct.
Step 4: Exclude distractors. Olanzapine, ziprasidone, and especially clozapine are relatively prolactin-sparing atypicals, so they are wrong.
Step 2: Compare the drugs. Risperidone is a potent \(D_2\) blocker (more potent than clozapine) with combined 5-HT2a and \(D_2\) antagonism, and it causes a marked, dose-related rise in prolactin.
Step 3: Conclude. Among the choices, risperidone produces the greatest hyperprolactinemia, so option D is correct.
Step 4: Exclude distractors. Olanzapine, ziprasidone, and especially clozapine are relatively prolactin-sparing atypicals, so they are wrong.
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