Clinical recommendationEvidence ratingReferences
FGAs with lower potency dopamine D2 neuroreceptor blockade (Table 1) are no more likely than most SGAs to cause extrapyramidal symptoms.A4, 5, 9
FGAs and the SGA risperidone (Risperdal) commonly cause hyperprolactinemia. Physicians should be vigilant for signs and symptoms of hyperprolactinemia in patients taking these medications.C6, 19
Patients taking SGAs, especially clozapine (Clozaril) and olanzapine (Zyprexa), should be monitored closely for weight gain and other metabolic syndrome–related adverse effects (Table 4).C39
Antipsychotic medications should be used with caution in older adults because of the risk of increased mortality from sudden cardiac death and cerebrovascular accidents.A4042