MSN 671 NEI GLOBAL VIDEO FINAL PAPER
2026 STUDY GUIDE DETAILED ANSWERS
READY
◉ Highest EPS risk antipsychotic class.
Answer: High-potency first-generation antipsychotics (FGAs) Haldol
& Prolixin (fluphenazine). It is reversible.
◉ Lowest EPS risk antipsychotics.
Answer: Clozapine and quetiapine (fast D2 dissociation).
◉ Cause of tardive dyskinesia.
Answer: Chronic D2 blockade → dopamine supersensitivity.
◉ Treatment for tardive dyskinesia.
Answer: It is irreversible. VMAT2 inhibitors (valbenazine,
deutetrabenazine), amantadine, switch to clozapine.
◉ Black Box Warning for antipsychotics.
Answer: ↑ Mortality in elderly patients with dementia-related
psychosis.
, ◉ Features of Neuroleptic Malignant Syndrome (NMS).
Answer: Rigidity, hyperthermia, AMS, autonomic instability, ↑ CK. It
is life threatening.
◉ Treatment of NMS.
Answer: Stop drug, ICU care, dantrolene, bromocriptine.
◉ Key metabolic labs before starting antipsychotics.
Answer: CBC, CMP, A1C, lipids, weight/BMI, vitals, ECG.
◉ SGAs with most metabolic risk.
Answer: Olanzapine, clozapine.
◉ Antipsychotics causing most prolactin elevation.
Answer: Risperidone and paliperidone.
◉ TCAs lethal in overdose.
Answer: Cardiac sodium channel blockade → fatal arrhythmias.
◉ SSRI mechanism of action.
Answer: Block SERT, ↑ serotonin in cleft.
2026 STUDY GUIDE DETAILED ANSWERS
READY
◉ Highest EPS risk antipsychotic class.
Answer: High-potency first-generation antipsychotics (FGAs) Haldol
& Prolixin (fluphenazine). It is reversible.
◉ Lowest EPS risk antipsychotics.
Answer: Clozapine and quetiapine (fast D2 dissociation).
◉ Cause of tardive dyskinesia.
Answer: Chronic D2 blockade → dopamine supersensitivity.
◉ Treatment for tardive dyskinesia.
Answer: It is irreversible. VMAT2 inhibitors (valbenazine,
deutetrabenazine), amantadine, switch to clozapine.
◉ Black Box Warning for antipsychotics.
Answer: ↑ Mortality in elderly patients with dementia-related
psychosis.
, ◉ Features of Neuroleptic Malignant Syndrome (NMS).
Answer: Rigidity, hyperthermia, AMS, autonomic instability, ↑ CK. It
is life threatening.
◉ Treatment of NMS.
Answer: Stop drug, ICU care, dantrolene, bromocriptine.
◉ Key metabolic labs before starting antipsychotics.
Answer: CBC, CMP, A1C, lipids, weight/BMI, vitals, ECG.
◉ SGAs with most metabolic risk.
Answer: Olanzapine, clozapine.
◉ Antipsychotics causing most prolactin elevation.
Answer: Risperidone and paliperidone.
◉ TCAs lethal in overdose.
Answer: Cardiac sodium channel blockade → fatal arrhythmias.
◉ SSRI mechanism of action.
Answer: Block SERT, ↑ serotonin in cleft.
