Medication	Initial dosage (mg per day)	Typical dosage range (mg per day)	Common adverse effects	Serious adverse effects	Comments	Cost*
First-generation antipsychotics
Chlorpromazine	25 to 100	200 to 800	Dry mouth, elevated prolactin levels, extrapyramidal symptoms, glucose intolerance, postural hypotension, somnolence, weight gain	Neuroleptic malignant syndrome, tardive dyskinesia	Has the most anticholinergic effects of the first-generation antipsychotics	$25 for 30 25-mg tablets
Fluphenazine	2.5 to 10	6 to 20	Akathisia, parkinsonism, dystonia, hyperprolactinemia	Neuroleptic malignant syndrome, tardive dyskinesia	—	$20 for 30 2.5-mg tablets
Haloperidol	1 to 15	5 to 20	Dry mouth, extrapyramidal symptoms, galactorrhea, hyperprolactinemia, hypotension, somnolence, tachycardia	Neuroleptic malignant syndrome, tardive dyskinesia, prolonged QT syndrome	—	$6 for 30 1-mg tablets
Loxapine	20	60 to 100	Dry mouth, extrapyramidal symptoms, galactorrhea, hyperprolactinemia, hypotension, somnolence, tachycardia	Neuroleptic malignant syndrome, tardive dyskinesia	—	$20 for 60 10-mg capsules
Perphenazine	8 to 16	8 to 32	Dry mouth, extrapyramidal symptoms, galactorrhea, hyperprolactinemia, hypotension, somnolence, tachycardia	Neuroleptic malignant syndrome, tardive dyskinesia	—	$16 for 30 8-mg tablets
Second-generation antipsychotics
Aripiprazole (Abilify)	10 to 15	10 to 15	Anxiety, constipation, dizziness, headache, insomnia	Agranulocytosis, neuroleptic malignant syndrome, tardive dyskinesia	May reduce hyperprolactinemia when used with other antipsychotics; does not impact lipids as much as other second-generation antipsychotics21	$10 ($580) for 30 10-mg tablets
Brexpiprazole (Rexulti)	1	2 to 4	Hyperlipidemia, weight gain, akathisia, somnolence	QT prolongation	—	$— ($1,300) for 30 1-mg tablets
Cariprazine (Vraylar)	1.5	1.5 to 6	Hyperprolactinemia, weight gain, somnolence	QT prolongation	—	$— ($1,300) for 30 1.5-mg capsules
Clozapine (Clozaril)	12.5 to 25	300 to 450	Hyperlipidemia, diabetes mellitus, orthostasis, seizures	Agranulocytosis (complete blood count should be obtained weekly for six months, then every two weeks for six months, then monthly), seizures, tardive dyskinesia, myocarditis	Primarily for treatment of severe refractory schizophrenia	$7 ($65) for 10 25-mg tablets
Lurasidone (Latuda)	40	40 to 160	Hyperlipidemia, diabetes, parkinsonism, somnolence, nausea	Neuroleptic malignant syndrome, tardive dyskinesia, QT prolongation	—	$— ($1,400) for 30 40-mg tablets
Olanzapine (Zyprexa)	5 to 10	10 to 20	Weight gain, hyperlipidemia, diabetes, akathisia, hyperprolactinemia, postural hypotension	Neuroleptic malignant syndrome, tardive dyskinesia	Do not use with benzodiazepines Patients who smoke may need a dose increase of 30% because of increased metabolism Increased incidence of weight gain compared with other second-generation antipsychotics20	$5 ($460) for 30 5-mg tablets
Paliperidone ER (Invega)	6	3 to 12	Hyperprolactinemia, hyperlipidemia, weight gain, priapism	Neuroleptic malignant syndrome, tardive dyskinesia	Is the active metabolite of risperidone	$90 ($370) for 30 6-mg tablets
Quetiapine (Seroquel)	Immediate release: 50 Extended release: 300	400 to 800	Hyperlipidemia, agitation, dizziness, dry mouth, hypotension, somnolence, weight gain	Agranulocytosis, neuroleptic malignant syndrome, tardive dyskinesia	Elevated discontinuation rate compared with other second-generation antipsychotics22	$4 ($200) for 30 50-mg tablets $7 ($500) for 30 300-mg tablets
Risperidone (Risperdal)	2	2 to 8	Anxiety, hyperprolactinemia, hypotension, insomnia, metabolic changes, nausea, weight gain	Agranulocytosis, neuroleptic malignant syndrome, tardive dyskinesia	Higher incidence of increased prolactin levels and extrapyramidal effects than other second-generation antipsychotics	$3 ($250) for 30 2-mg tablets
Ziprasidone (Geodon)	40	80 to 160	Agitation, hypotension, metabolic changes, nausea, somnolence, tachycardia, weight gain	Agranulocytosis, neuroleptic malignant syndrome, tardive dyskinesia	Least amount of weight gain compared with other atypical antipsychotics	$8 ($600) for 30 40-mg capsules