A 24-year-old with schizophrenia has experienced headaches and erectile dysfunction while on antipsychotic medication. Which drug is most likely responsible?

The situation described involves a young adult with schizophrenia experiencing headaches and erectile dysfunction while on antipsychotic medication. Haloperidol, an antipsychotic medication classified as a typical antipsychotic, is known for its side effects that include extrapyramidal symptoms (which can lead to headaches) and sexual dysfunction, including erectile dysfunction.

Typical antipsychotics like Haloperidol can block dopamine receptors in the brain, leading to various side effects related to both movement and hormonal changes. The blockade of dopamine can also have an impact on prolactin levels, which frequently results in sexual side effects, including erectile dysfunction.

In contrast, the other medications listed—Fluoxetine and Citalopram (both selective serotonin reuptake inhibitors) and Clozapine (an atypical antipsychotic)—are generally associated with different side effect profiles. SSRI antidepressants can potentially lead to sexual dysfunction as well, but they are less commonly linked to headaches as a direct side effect related to their mechanism of action. Clozapine, while an atypical antipsychotic, tends to have a lower risk of causing extrapyramidal symptoms and associated hormonal side effects compared to Haloperidol.

Thus, the side effects of headaches and