A 22-year-old man with a first episode of schizophrenia is started on a second-generation antipsychotic. After three weeks his auditory hallucinations diminish substantially, but he remains socially withdrawn, unmotivated, and emotionally flat. His family asks why these symptoms persist.
The clinician's best explanation is:
- A
These behaviors indicate the patient is faking improvement.
- B
Negative symptoms always disappear once positive symptoms remit.
- Ccheck_circle
Antipsychotics are most effective for positive symptoms; negative symptoms typically respond less robustly.
- D
The medication has failed and must be discontinued immediately.
Explanation
Antipsychotics, especially through dopamine D2 antagonism, primarily reduce positive symptoms (hallucinations, delusions) and have weaker effects on negative symptoms (avolition, flat affect). The other options misrepresent treatment response, prematurely abandon a working medication, or pathologize the patient.