Question

Which of the following antipsychotic have increased prolactin secretion

• A. Olanzapine
• B. Ziprasidone
• C. Clozapine
• D. Risperidone

Answer 1

The Correct Option is D

Step 1: The rule of thumb: tonic dopamine inhibits prolactin, so the more tightly an antipsychotic occupies D2 receptors in the tuberoinfundibular pathway, the higher the prolactin climbs.
Step 2: Among the choices, risperidone is the strongest D2 antagonist - even more potent than clozapine - while also blocking 5-HT2a, alpha1, alpha2 and H1 receptors. Its robust D2 blockade reliably elevates serum prolactin.
Step 3: Clinically risperidone improves schizophrenia symptoms, and extrapyramidal effects stay low only at doses under about 6 mg/day; postural hypotension and agitation can also occur.
Step 4: Clozapine, olanzapine and ziprasidone bind D2 loosely, so they are considered prolactin-sparing, leaving risperidone as the answer.
\[\boxed{\text{Risperidone}}\]