Which psychiatric drug does not need any test dose before starting the routine dose?

Correct option is A

Haloperidol, a first-generation (typical) antipsychotic, can be started directly at a clinically appropriate dose without the requirement of a test dose. Although patients should be monitored for extrapyramidal symptoms (EPS) and QT prolongation, there is no specific test dose protocol mandated before initiating haloperidol therapy. It is routinely used in emergency psychiatric settings and general practice.

Explanation of options:

• (a) Haloperidol:
  Correct. No test dose is needed; standard initial dosing and clinical monitoring are sufficient.
• (b) Risperidone:
  Requires gradual dose titration, especially in elderly and renal-impaired patients. Not associated with a test dose, but not the best choice for this question.
• (c) Clozapine:
  Test dose and mandatory blood monitoring required. Clozapine can cause agranulocytosis, so baseline and weekly WBC/ANC counts are mandatory before and during treatment.
• (d) Quetiapine:
  Requires slow titration to reduce risk of orthostatic hypotension and sedation, though not a formal test dose—it still isn’t initiated abruptly.