Which of the following is an extrapyramidal side effect associated with first-generation antipsychotics?

• A. Hypertension.
• B. Parkinsonism.
• C. Hair loss.
• D. Night blindness.

Answer: (B)

Extrapyramidal symptoms come from blocking dopamine D2 receptors in motor pathways outside the pyramidal tract, especially in the nigrostriatal system. When first-generation antipsychotics strongly antagonize these D2 receptors, motor control circuits lose dopaminergic signaling, producing parkinsonian features such as slowed movement, stiffness, tremor, and a masked facial expression. That Parkinsonism pattern is a hallmark extrapyramidal side effect, which is why it’s the correct choice here.

Hypertension, hair loss, and night blindness aren’t typical extrapyramidal motor effects. Hypertension is a cardiovascular issue, hair loss isn’t a classic dopaminergic motor side effect, and night blindness isn’t associated with D2 blockade in these drugs.