Atypical Antipsychotics: What You Need to Know
Atypical antipsychotics are a group of medicines commonly used for schizophrenia, bipolar disorder, and as add-ons for depression. They usually cause fewer movement side effects than older antipsychotics, but they bring other risks you should know about. This page gives straightforward facts so you can talk with your clinician and watch for problems early.
Common drugs and how they're used
Some names you’ll often hear: risperidone, olanzapine, quetiapine, aripiprazole, ziprasidone, and clozapine. Each one behaves a bit differently:
- Risperidone: used for psychosis and agitation; can raise prolactin.
- Olanzapine: effective but often linked to weight gain and metabolic changes.
- Quetiapine: used for psychosis and bipolar depression; sedating at lower doses.
- Aripiprazole: tends to be activating for some people and may cause less weight gain.
- Ziprasidone: lower risk of weight gain but sometimes requires an ECG because it can affect heart rhythm.
- Clozapine: reserved for treatment-resistant psychosis; needs blood monitoring because of a rare but serious drop in white blood cells.
Doctors pick a drug based on symptoms, past reactions, medical history, and side effect risk. If one medicine doesn't work or causes trouble, there are usually alternatives and safe ways to switch under clinical supervision.
Side effects, monitoring, and practical tips
Watch for weight gain, increased appetite, high blood sugar, and abnormal cholesterol—these are common with many atypicals. You might also notice drowsiness, dry mouth, constipation, or more rarely, movement symptoms like tremor or stiffness.
Basic monitoring that helps keep you safe: check weight, waist size, fasting blood glucose or A1c, and lipids before and after starting a drug. If you're on ziprasidone, ask your doctor about a baseline ECG. If prescribed clozapine, expect regular blood tests (weekly at first) to watch white blood cell counts.
A few practical tips: ask about likely side effects before you start, weigh yourself weekly for the first three months, and get repeat blood tests as your doctor recommends. If you notice sudden fever, sore throat, or mouth sores on clozapine, contact your provider immediately. If you feel very sleepy, excessively restless, or have new muscle problems, tell your clinician—sometimes a dose change or different drug fixes it.
Finally, don’t stop these medicines suddenly. Stopping quickly can cause withdrawal or relapse. If you want to change or stop, plan a gradual approach with your prescriber. Bringing a family member or friend to appointments helps—side effects are easier to spot with someone who sees daily changes.
If you have questions about a specific drug or lab plan, use the site's articles or ask your prescriber for a written plan you can follow at home.
