Which second-generation antipsychotic is commonly used as a first-line option for psychosis?

• A. Risperidone.
• B. Haloperidol.
• C. Fluphenazine.
• D. Chlorpromazine.

Answer: (A)

Second-generation antipsychotics are often chosen first for psychosis because they treat symptoms with a lower risk of extrapyramidal side effects compared with older agents. Risperidone stands out as a commonly used first-line option among these drugs due to solid efficacy and a generally tolerable side effect profile, making it a go-to starting therapy. It still carries risks, such as potential weight gain and hyperprolactinemia at higher doses, but these are weighed against the high EPS risk seen with first-generation antipsychotics.

The other options are traditional first-generation antipsychotics, which are more likely to cause movement disorders like dystonia, parkinsonism, and tardive dyskinesia, and may have other burdensome effects (for example, chlorpromazine can cause sedation and anticholinergic symptoms). That's why they’re less favored as initial therapy when a second-generation agent like risperidone is an appropriate choice.