Which prescribing pattern carries the greatest risk of precipitating neuroleptic malignant syndrome?

• A Low-dose risperidone continued unchanged for two years
• B Aripiprazole switched from oral to the same dose by mouth dissolving tablet
• C Intermittent low-dose quetiapine taken at bedtime
• D Rapid dose escalation of a high-potency typical antipsychotic given parenterally ✓

Explanation

NMS risk rises with high-potency dopamine antagonists such as haloperidol and fluphenazine, rapid upward titration, parenteral routes, dehydration, and physical exhaustion. Long-term stable dosing, low-potency agents, and partial agonists carry far lower risk. Route and rate of escalation matter more than cumulative years of exposure.

Reference: Kaplan and Sadock's Synopsis of Psychiatry, 12th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.