Examples of typical antipsychotics include: Atypical, or second generation, antipsychotics are less prone to inducing sedation although some atypical antipsychotic drugs are still associated with extreme tiredness and may shift sleep patterns.

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The first-generation antipsychotics (FGAs) work through dopamine D neuroreceptor blockade, and a subsequent series of new antipsychotics were developed with stronger dopamine blockade.1 To discuss differences in the adverse effect profiles of FGAs, we use the terms “low-potency” and “high-potency,” not to indicate their clinical effectiveness, but rather to indicate their potency in binding to this dopamine DSecond-generation antipsychotics (SGAs) were launched in 1989 when investigators found that clozapine (Clozaril) was more effective than chlorpromazine, with fewer extrapyramidal symptoms.2 These new anti-psychotics were considered atypical because they targeted neuroreceptors other than only dopamine.

Over the past two decades, SGAs have dominated prescribing preferences in the United States under the assumption that they are more effective and safer than FGAs.3 Paliperidone, the active metabolite of risperidone, has been marketed in the United States as Invega since 2007.

There is insufficient long-term clinical information on this medication to include it in this review.

It is likely that the adverse effect profile of Invega will be similar to that of risperidone Paliperidone, the active metabolite of risperidone, has been marketed in the United States as Invega since 2007.

It is likely that the adverse effect profile of Invega will be similar to that of risperidone The results of two recent publicly funded studies designed to evaluate the effectiveness of these treatments under real-world conditions have called into question these prescribing preferences.

The Clinical Anti-psychotic Trials of Intervention Effectiveness study was designed to compare the FGA perphenazine with several SGAs, using “all-cause discontinuation” as a proxy measure for effectiveness.4 The Cost Utility of the Latest Antipsychotic Drugs in Schizophrenia Study measured quality of life and other effectiveness measures.5 Neither study demonstrated a clear difference in effectiveness between FGAs and non-clozapine SGAs.Also, as a class, the older first-generation antipsychotics are more likely to be associated with movement disorders, but this is primarily true of medications that bind tightly to dopaminergic neuroreceptors, such as haloperidol, and less true of medications that bind weakly, such as chlorpromazine.Anticholinergic effects are especially prominent with weaker-binding first-generation antipsychotics, as well as with the second-generation antipsychotic clozapine.Antipsychotics are also known as major tranquilizers and are sometimes used to treat sleep disorders due to their sedating effects.How sedating an antipsychotic is depends on dose and type.For information about the SORT evidence rating system, go to https://org/A = consistent, good-quality patient-oriented evidence; B = inconsistent or limited-quality patient-oriented evidence; C = consensus, disease-oriented evidence, usual practice, expert opinion, or case series.