Rosh Psychiatry Board Practice Exam

What is the most likely cause of persistent generalized restlessness in a patient taking risperidone?

1. Amlodipine

2. Losartan

3. Restless leg syndrome

4. Risperidone

The correct answer is: Risperidone

Persistent generalized restlessness in a patient taking risperidone is most likely attributable to the medication itself, as risperidone can lead to extrapyramidal side effects, one of which is akathisia. Akathisia manifests as an inner feeling of restlessness or the inability to stay still, often resulting in significant discomfort for the patient. This phenomenon is particularly associated with the use of antipsychotic medications, including risperidone, due to their influence on dopamine pathways in the central nervous system. While other factors or conditions could potentially contribute to restlessness, such as a medication related to blood pressure management or an independent condition like restless leg syndrome, the direct connection of persistent restlessness with the use of risperidone makes it the most likely cause in this context. It is important for clinicians to monitor for these side effects in patients who are prescribed antipsychotics and to implement strategies for management, which might include adjustment of the dosage or consideration of alternative treatments.