Which of the following drugs is known to potentially cause extra-pyramidal symptoms?

Risperidone, a medication commonly used to treat schizophrenia and bipolar disorder, is an atypical antipsychotic. One of its known side effects includes the potential for extra-pyramidal symptoms (EPS), which are drug-induced movement disorders that can manifest as tremors, rigidity, bradykinesia, or tardive dyskinesia. Atypical antipsychotics like risperidone are less likely to cause EPS compared to older, typical antipsychotics, but they still present a risk, especially at higher doses or in certain sensitive populations, such as older adults.

In contrast, cholinesterase inhibitors such as Aricept primarily treat symptoms of Alzheimer's disease and do not typically result in extra-pyramidal symptoms. Amitriptyline, a tricyclic antidepressant, can cause a variety of side effects related to its anticholinergic properties but is not associated with EPS. Similarly, fluoxetine, a selective serotonin reuptake inhibitor (SSRI), is used to treat depression and anxiety, and it does not cause EPS. Thus, risperidone stands out as the drug in this context with a recognized potential to cause extra-pyramidal symptoms.