A 21-year-old patient with schizoaffective disorder experienced a major reduction in mood and psychotic symptoms while taking risperidone (Risperdal). However, they also developed muscle rigidity and an ongoing tremor. They decline to take another medication to treat these side effects. Instead, they would prefer to try a different antipsychotic medication. They have a history of rapid weight gain on olanzapine (Zyprexa), which led to discontinuation. After receiving psychoeducation, they agreed to pharmacogenomic testing, which demonstrated that they were a poor metabolizer at cytochrome P450 2D6 and P450 3A4. Which of the following medications is the most appropriate choice?
Clozapine (Clozaril)
B
Haloperidol (Haldol)
C
Lurasidone (Latuda)
D
Paliperidone (Invega)