Which of the following is an antipsychotic with strong anticholinergic properties?

• A. Clozapine
• B. Quetiapine
• C. Haloperidol
• D. Sertraline

Answer: (A)

Clozapine stands out because it blocks muscarinic (anticholinergic) receptors more strongly than most antipsychotics. That makes it have a high anticholinergic burden, leading to effects like constipation, dry mouth, blurred vision, urinary retention, and cognitive changes. In older adults, these anticholinergic effects increase the risk of delirium, confusion, constipation, and falls, which is why strong anticholinergic properties are a concern in Beers Criteria. Among the options, clozapine has the strongest anticholinergic activity; quetiapine has some anticholinergic effects but less; haloperidol has minimal anticholinergic activity and more EPS risk; sertraline is an antidepressant, not an antipsychotic, and does not carry strong anticholinergic effects.