Which two drugs require monitoring for orthostatic hypotension according to the source?

• A. Iloperidone only
• B. Iloperidone and Risperidone
• C. Risperidone only
• D. Quetiapine and Ziprasidone

Answer: (B)

Orthostatic hypotension with antipsychotics is mainly about alpha-1 adrenergic blockade and the body's ability to adjust blood pressure when you stand up. Iloperidone and risperidone have notable alpha-1 blocking effects, which can blunt the normal vasoconstrictive response and cause a drop in blood pressure upon standing, especially when starting treatment or increasing the dose. Because this risk is most evident during initiation and dose changes, the source recommends monitoring blood pressure and symptoms of lightheadedness or dizziness with these two drugs. Other antipsychotics can occasionally cause orthostatic symptoms, but the guidance cited specifically calls for monitoring with iloperidone and risperidone, making them the two drugs most associated with this monitoring need.