Question

scenario: a patient with schizophrenia is started on an antipsychotic. they report worsening of negative symptoms. question: what is a possible explanation according to nei psychopharm? excessive dopamine blockade in the mesolimbic pathway. excessive dopamine blockade in the mesocortical pathway. increased serotonin activity. increased glutamate activity.

Explanation:

To determine the answer, we analyze each option:

• The mesolimbic pathway is associated with positive symptoms (e.g., hallucinations, delusions) of schizophrenia. Blocking dopamine here helps with positive symptoms, not worsening negative symptoms. So the first option is incorrect.
• The mesocortical pathway is linked to negative symptoms (e.g., avolition, anhedonia) of schizophrenia. Excessive dopamine blockade in this pathway can worsen negative symptoms, which aligns with the patient's report.
• Increased serotonin activity is more related to side effects like extrapyramidal symptoms or impact on other neurotransmitter interactions, not directly worsening negative symptoms in this context. So this option is less likely.
• Increased glutamate activity: Glutamate dysregulation is involved in schizophrenia, but increased glutamate activity isn't a typical explanation for worsening negative symptoms due to antipsychotic - induced dopamine blockade. So this option is incorrect.

Answer:

B. Excessive dopamine blockade in the mesocortical pathway.