Which of the following medications is NOT a known cause of extrapyramidal symptoms?

Fluoxetine is an antidepressant that belongs to the class of selective serotonin reuptake inhibitors (SSRIs). It primarily works by increasing the levels of serotonin in the brain, which helps improve mood and reduce symptoms of depression. Unlike antipsychotic medications such as haloperidol, Thorazine (chlorpromazine), and Compazine (prochlorperazine), fluoxetine does not have a significant effect on the dopaminergic pathways that are associated with the development of extrapyramidal symptoms (EPS).

Extrapyramidal symptoms are movement disorders that can be caused by medications that block dopamine receptors, particularly in the central nervous system. Typical antipsychotics, like haloperidol and Thorazine, are well-known for this side effect due to their strong dopamine antagonism. Compazine, although primarily an antiemetic, also has antipsychotic properties and can lead to EPS as well. In contrast, fluoxetine's mechanism of action targets serotonin rather than dopamine, making it less likely to produce extrapyramidal symptoms. This is why fluoxetine is recognized as the medication that does not contribute to these adverse effects.