Which drug is identified as having the lowest risk for extrapyramidal symptoms?

Clozapine is identified as having the lowest risk for extrapyramidal symptoms among the options provided. This is because clozapine is an atypical antipsychotic, which generally affects multiple neurotransmitter systems, including serotonin receptors, and has a lower affinity for dopamine D2 receptors compared to typical antipsychotics. The low affinity for D2 receptors results in fewer movement-related side effects, which are characteristic of extrapyramidal symptoms.

In contrast, risperdal (risperidone) and haloperidol, both of which are antipsychotic medications, have a higher likelihood of inducing extrapyramidal symptoms due to their stronger dopamine receptor antagonism. Risperidone, especially at higher doses, can lead to increased risk of these motor side effects. Haloperidol, being a typical antipsychotic, is notorious for causing extrapyramidal reactions like tremors and rigidity.

Fluoxetine, while an antidepressant rather than an antipsychotic, also does not carry a significant risk of extrapyramidal symptoms. Still, it is not considered in the same context as the other antipsychotic medications when evaluating the specific risk for these symptoms. Therefore, clozapine stands out as the