All of the following are second generation antipsychotics except

A. Lacks empathy. Individuals with narcissistic personality disorder (NPD) show a profound lack of empathy, often disregarding the feelings and needs of others. They may appear emotionally detached and struggle to recognize or validate other people’s experiences, leading to superficial and exploitative relationships.

B. Takes advantage of others. A key characteristic of NPD is a pattern of exploiting others for personal gain, whether in professional, social, or personal relationships. Individuals with NPD often manipulate people to maintain their sense of superiority and entitlement, showing little remorse for their actions.

C. Needs constant admiration. People with NPD have an excessive need for admiration and validation to support their inflated self-image. They may seek praise, attention, and recognition, becoming defensive or hostile when they feel unappreciated or criticized.

D. Mood swings. While mood instability can occur in response to narcissistic injury (perceived criticism or rejection), frequent and extreme mood swings are more characteristic of borderline personality disorder (BPD) or mood disorders like bipolar disorder. NPD primarily involves grandiosity, entitlement, and emotional detachment, rather than rapid emotional shifts.

A. Mesolimbic pathway is associated with reward, motivation, and emotions and is hyperactive in schizophrenia, leading to positive symptoms such as hallucinations, delusions, and disorganized thinking. Antipsychotic medications work by blocking dopamine (D2) receptors in this pathway, reducing psychotic symptoms.

B. Nigrostriatal pathway controls motor function and coordination. Dopamine blockade in this pathway leads to extrapyramidal symptoms (EPS) such as tremors, rigidity, and tardive dyskinesia, which are common side effects of first-generation antipsychotics (typical antipsychotics).

C. Tuberoinfundibular pathway regulates prolactin secretion. Dopamine inhibits prolactin release, so blocking D2 receptors with antipsychotics leads to increased prolactin levels, causing gynecomastia, galactorrhea, and menstrual irregularities.

D. Mesocortical pathway is responsible for cognition, motivation, and emotional regulation. In schizophrenia, this pathway is hypoactive, contributing to negative symptoms such as apathy, social withdrawal, and cognitive impairment.