Atypical antipsychotics: Uses, side effects, examples Health ConditionsHealth ConditionsAlzheimer's & DementiaAnxietyArthritisAsthma & AllergiesBreast CancerCancerCardiovascular HealthCOVID-19Dermatology & SkincareDiabetesEnvironment & SustainabilityExercise & FitnessEye HealthHeadache & MigraineHealth EquityHIV & AIDSHuman BiologyInflammatory Bowel DiseaseLeukemiaLGBTQIA+Men's HealthMental HealthMultiple Sclerosis (MS)NutritionParkinson's DiseasePsoriasisSexual HealthWomen's HealthDiscoverNewsLatest NewsOriginal SeriesMedical MythsHonest NutritionThrough My EyesNew Normal HealthPodcastsHow to understand chronic painWhat is behind vaccine hesitancy?The amazing story of hepatitis C, from discovery to cureNew directions in dementia researchCan psychedelics rewire a depressed, anxious brain?Why climate change matters for human healthToolsGeneral HealthDrugs A-ZHealth HubsHealth ToolsBMI Calculators and ChartsBlood Pressure Chart: Ranges and GuideBreast Cancer: Self-Examination GuideSleep CalculatorHealth ProductsAffordable Therapy OptionsBlood Pressure MonitorsDiabetic SuppliesFitness TrackersHome GymsGreen Cleaning ProductsHow to Shop for CBDQuizzesRA Myths vs FactsType 2 Diabetes: Managing Blood SugarAnkylosing Spondylitis Pain: Fact or FictionConnectAbout Medical News TodayWho We AreOur Editorial ProcessContent IntegrityConscious LanguageNewslettersSign UpFollow UsMedical News TodayHealth ConditionsDiscoverToolsConnectSubscribe What are atypical antipsychotics Medically reviewed by Jennie Olopaade, PharmD, RPH — By Jessica Caporuscio, Pharm.D. on September 28, 2022There are two types of antipsychotic drugs: typical and atypical. Atypical antipsychotics usually have fewer and less severe side effects, so doctors often prescribe them over typical antipsychotics. Doctors prescribe atypical antipsychotics to treat a range of mental health conditions, including schizophrenia, obsessive-compulsive disorder (OCD), and treatment-resistant mania. They may also prescribe atypical antipsychotics off-label for other conditions, such as Tourette’s syndrome. One example of a typical antipsychotic drug is prochlorperazine (Procomp). An example of an atypical antipsychotic drug is risperidone (Risperdal). Keep reading to learn about the differences between typical and atypical antipsychotics, their uses, side effects, and more. Atypical vs typical antipsychotics Share on PinterestDavid Wall/Getty ImagesTypical antipsychotics were the first in their drug class and are sometimes called first-generation antipsychotics. They act on dopamine receptors in the brain. Drug manufacturers later developed second-generation antipsychotics, which are also called atypical antipsychotics. They act on both dopamine and serotonin receptors. Atypical antipsychotics also have some antidepressant effects when used alone or with an antidepressant. The main advantage of atypical antipsychotics is that they have fewer and less severe side effects than typical antipsychotics. Side effects The most significant difference between typical and atypical antipsychotics is their side effects. Typical antipsychotics have significant extrapyramidal symptoms. These are drug-induced movement disorders. They may include:Dystonia: uncontrolled muscle contractions that cause repetitive movements and abnormal postureAkathisia: a state of restlessnessParkinsonism: a disorder causing tremors, slow movements, and rigidityTardive dyskinesia: a chronic condition causing repetitive muscle movements in the face, neck, arms, and legsTardive akathisia: a delayed start of akathisia after starting an antipsychotic drug Extrapyramidal symptoms can be debilitating. Some people report the symptoms interfere with activities of daily living, social functioning, and speaking. Other possible side effects of antipsychotics include:dry mouthconstipationurinary retentionallergic reactions Severe side effects of antipsychotics may affect heart function. Because antipsychotics act on dopamine receptors, they may increase a person’s level of prolactin. This is a hormone released in the pituitary gland. High prolactin levels in the blood can cause:abnormal breast milk productionbreast enlargementloss of menstrual periodsimpotence in malesloss of orgasm in females A note about sex and gender Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more. Although atypical antipsychotics have less significant side effects, they can cause: weight gainhigh cholesteroldiabetes One atypical antipsychotic called clozapine carries a risk of myocarditis, which is inflammation of the heart muscle. However, the risk of dying from myocarditis from taking clozapine is low. Antipsychotics have a boxed warning issued by the Food and Drug Administration (FDA). This is the most severe warning for a drug. List of atypical antipsychotics The following table lists examples of typical and atypical antipsychotics:Typical antipsychotics Atypical antipsychoticsacetophenazine (Tindal)aripiprazole (Abilify)haloperidol (Haldol)asenapine (Saphris)loxapine (Adasuve)brexpiprazole (Rexulti)molindonecariprazine (Vraylar)perphenazineclozapine (Clozaril)pimozideiloperidone (Fanapt)prochlorperazine (Procomp)lurasidone (Latuda)thiothixeneolanzapine (Zyprexa)trifluoperazinepaliperidone (Invega)quetiapine (Seroquel)risperidone (Risperdal)ziprasidone (Geodon) Conditions that atypical antipsychotics can treat The FDA has approved antipsychotics for various psychiatric conditions. Different types of antipsychotics and the conditions they treat are listed below:Typical antipsychotics Typical or atypical antipsychotics (except clozapine)Clozapinedelusional disordersschizophreniachildhood schizophreniaTourette’s syndromeschizoaffective disordertardive dyskinesiamajor depressive disorder (with psychotic characteristics)treatment-resistant maniaborderline personality disorder (BPD)obsessive-compulsive disorder (OCD)dementiachildhood autismsubstance-induced psychotic disorderParkinson’s diseasesudden manic episodeHuntington’s diseaseschizophrenia or schizoaffective disorder (with suicidal thoughts)severe psychotic symptoms Sometimes, doctors may prescribe atypical antipsychotics for conditions the FDA has not approved them for. This is called off-label prescribing. For example, atypical antipsychotics may help people with Tourette’s syndrome, but this is an off-label use. However, doctors can sometimes incorrectly prescribe antipsychotics. A concerning practice seen in some care homes is doctors overprescribing antipsychotic medications to older adults. Off-label uses of antipsychotics in older adults in nursing homes include dementia-related behaviors, such as aggression and agitation. Antipsychotics are not safe when prescribed inappropriately to a vulnerable group of people. National programs in the United States have worked to reduce the unsuitable prescribing of antipsychotics in nursing homes. While researchers note a decline in this practice, more work is needed to further reduce the improper prescribing of antipsychotics in nursing homes. Contacting a doctor When taking antipsychotic medications, people should report any side effects to a doctor. Sometimes, changing antipsychotics can help improve the medical condition while minimizing side effects. If a person is taking atypical antipsychotics, doctors will review their body weight and order blood tests to check for increased cholesterol and blood sugar. Follow-up appointments may also include having an electrocardiogram to evaluate heart function. For people taking clozapine, doctors will check neutrophil levels. This is a type of white blood cell that helps the body protect itself from infections. Clozapine can drop neutrophil levels and increase a person’s risk of illnesses. Summary Doctors can prescribe a range of types of antipsychotics. Each type has different side effects. While some health conditions require a typical antipsychotic medication, atypical antipsychotics are often preferred. Atypical antipsychotic medications usually have fewer and less severe side effects than typical antipsychotic medications. Weight gain, diabetes, and high cholesterol are side effects that can occur with atypical antipsychotics. When taking antipsychotics, follow-up appointments with a doctor are crucial to a person’s care. Last medically reviewed on September 28, 2022Mental HealthPsychology / PsychiatryDrugs 4 sourcescollapsedMedical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Chokhawala, K., et al. (2022). Antipsychotic medications.https://www.ncbi.nlm.nih.gov/books/NBK519503/D'Souza, R. S., et al. (2022). Extrapyramidal symptoms.https://www.ncbi.nlm.nih.gov/books/NBK534115/Fashaw, S., et al. (2020). Inappropriate antipsychotic use: The impact of nursing home socioeconomic and racial composition.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7110922/Willner, K., et al. (2022). Atypical antipsychotic agents. https://www.ncbi.nlm.nih.gov/books/NBK448156/FEEDBACK:Medically reviewed by Jennie Olopaade, PharmD, RPH — By Jessica Caporuscio, Pharm.D. on September 28, 2022 Latest newsWhat sets 'SuperAgers' apart? Their unusually large neuronsOmega-3 may provide a brain boost for people in midlifeSeasonal affective disorder (SAD): How to beat it this fall and winterCDC: Monkeypox in the US 'unlikely to be eliminated in the near future'Why are more women prone to Alzheimer's? New clues arise Related CoverageWhat to know about antipsychotic medicationsMedically reviewed by Nicole Washington, DO, MPH Doctors prescribe antipsychotic medications to treat psychosis, a symptom of several mental health conditions. Learn more.READ MORE10 ways to lose weight gained from medicationsMedically reviewed by Daniel Bubnis, M.S., NASM-CPT, NASE Level II-CSS Find out how to lose weight that is due to medication using 10 methods. 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