Which antipsychotic is Not recommended?

• A. Asenapine
• B. Clozapine
• C. Iloperidone
• D. Lurasidone

Answer: (C)

Iloperidone is not recommended because it has a notable cardiovascular risk during initiation and dose increases. It can cause significant orthostatic hypotension and prolong the QT interval, which raises the risk of dizziness, fainting, and potentially serious arrhythmias. In people with HIV on antiretroviral therapy, who may have electrolyte disturbances or be taking other QT-prolonging drugs, this combination heightens safety concerns and necessitates very careful monitoring and slow titration. Those safety issues make iloperidone less suitable in this context, whereas the other antipsychotics have different risk profiles that do not carry the same immediate cardiovascular cautions.