Medication	Dosage (mg per day)	Common adverse effects	Serious adverse effects	Comments	Monthly cost*
First generation
Chlorpromazine	300 to 1,000	Drowsiness, dry mouth, elevated prolactin levels, extrapyramidal symptoms, glucose intolerance, postural hypotension, weight gain	Neuroleptic malignant syndrome, tardive dyskinesia	First drug used to treat psychosis	$235 to $590
Haloperidol	5 to 20	Drowsiness, dry mouth, extrapyramidal symptoms, galactorrhea, hypotension, tachycardia	Neuroleptic malignant syndrome, prolonged QT interval, tardive dyskinesia	More effective for treating positive symptoms,13 but has a high risk of extrapyramidal symptoms14	$5 to $30
Perphenazine	16 to 64	Drowsiness, dry mouth, extrapyramidal symptoms, galactorrhea, hypotension, tachycardia	Neuroleptic malignant syndrome, tardive dyskinesia	—	$55 to $215
Thiothixene	15 to 60	Drowsiness, dry mouth, extrapyramidal symptoms, galactorrhea, hypotension, tachycardia	Neuroleptic malignant syndrome, tardive dyskinesia	—	$35 to $45
Second generation
Aripiprazole (Abilify)	10 to 30	Anxiety, constipation, dizziness, headache, insomnia, metabolic changes, nausea, vomiting	Agranulocytosis, neuroleptic malignant syndrome, tardive dyskinesia	Smaller effect on lipids compared with other second-generation antipsychotics15	($825 to $1,165 brand)
Clozapine (Clozaril)	150 to 600	Constipation, dizziness, headache, metabolic effects, salivation, sedation, tachycardia, weight gain	Agranulocytosis (complete blood count should be obtained weekly for six months, then every two weeks for six months, then monthly), myocarditis, seizures, tardive dyskinesia	Reserved for severe, treatment-refractory schizophrenia11	$80 to $200 ($510 to $2,010 brand)
Lurasidone (Latuda)	40 to 160	Akathisia, hyperprolactinemia, metabolic changes, nausea, parkinsonism, somnolence	Neuroleptic malignant syndrome, tardive dyskinesia	Higher incidence of adverse effects with higher dosages16	($745 to $1,490 brand)
Olanzapine (Zyprexa)	10 to 30	Akathisia, constipation, dizziness, hyperprolactinemia, metabolic changes, postural hypotension, weight gain	Agranulocytosis, neuroleptic malignant syndrome, tardive dyskinesia	More weight gain compared with older second-generation antipsychotics, but a lower discontinuation rate17,18	$15 to $45 ($590 to $1,760 brand)
Paliperidone (Invega)	3 to 12	Hyperprolactinemia, metabolic changes, orthostatic hypotension, priapism, somnolence, weight gain	Neuroleptic malignant syndrome, prolonged QT interval, tardive dyskinesia	Active metabolite of risperidone	($775 to $1,550 brand)
Quetiapine (Seroquel)	300 to 800	Agitation, dizziness, dry mouth, headache, metabolic changes, postural hypotension, somnolence, weight gain	Agranulocytosis, neuroleptic malignant syndrome, tardive dyskinesia	High discontinuation rate compared with other second-generation antipsychotics19	$25 to $45 ($530 to $1,235 brand)
Risperidone (Risperdal)	2 to 8	Anxiety, hyperprolactinemia, hypotension, insomnia, metabolic changes, nausea, weight gain	Agranulocytosis, neuroleptic malignant syndrome, tardive dyskinesia	Higher incidence of extrapyramidal effects, increased prolactin levels18,20	$10 to $20 ($400 to $1,255 brand)
Ziprasidone (Geodon)	120 to 200	Agitation, hypotension, metabolic changes, nausea, somnolence, tachycardia, weight gain	Agranulocytosis, neuroleptic malignant syndrome, tardive dyskinesia	Least amount of weight gain compared with other second-generation antipsychotics21	$135 to $170 ($830 to $1,060 brand)