Which adverse effect is commonly associated with first-generation antipsychotics that benztropine helps prevent?

• A. Metabolic syndrome
• B. Sedation
• C. Extrapyramidal symptoms
• D. Hyperprolactinemia

Answer: (C)

First-generation antipsychotics block dopamine in the nigrostriatal pathway, which disrupts motor control and leads to extrapyramidal symptoms such as acute dystonia, parkinsonism, and akathisia. Benztropine is an anticholinergic that reduces acetylcholine activity in the same brain region, helping to rebalance dopamine and acetylcholine and prevent these motor side effects. This is why benztropine is used to prevent extrapyramidal symptoms. Other common antipsychotic side effects, like metabolic syndrome and hyperprolactinemia, arise from dopamine blockade in other pathways and aren’t specifically mitigated by benztropine, and sedation isn’t the primary target of this drug.