Antipsychotic Drugs

Drug

Some Side Effects

Comments

First-generation antipsychotic drugs

Dry mouth

Blurred vision

Seizures

Increased heart rate and decreased blood pressure

Constipation

Sudden but often reversible tremor and muscle stiffness that may progress to rigidity

Involuntary movements of the face and arms (tardive dyskinesia)

Muscle rigidity, fever, high blood pressure, and changes in mental function (neuroleptic malignant syndrome)

Side effects are much more likely in older people and in people with impaired balance or serious medical disorders.

Second-generation antipsychotic drugs

Drowsiness and weight gain (most common), which can be substantial

metabolic syndrome)

Newer antipsychotic drugs are less likely to cause tremor, muscle stiffness, involuntary movements (including tardive dyskinesia), and neuroleptic malignant syndrome, but other side effects may occur.

is used much less often because it can cause bone marrow suppression, a reduced white blood cell count, and seizures. However, it is often effective in people who are not responsive to other antipsychotic drugs.

and are most likely to cause weight gain, and is the least likely.

does not cause weight gain but may lead to abnormalities on an electrocardiogram.

, , , and are less likely to cause metabolic syndrome.

has a lower risk of motor and metabolic side effects, but it is contraindicated in older people with dementia-related psychosis.

* Available as a long-acting intramuscular (IM) injection for people who have difficulty taking oral drugs.