Antipsychotics: Atypical

Key points

• Atypicals (olanzapine, risperidone, quetiapine, clozapine): less extrapyramidal effect than typicals; action includes 5-HT2 antagonism.
• Metabolic side effects prominent: weight gain, type 2 diabetes, dyslipidaemia (especially olanzapine).
• Olanzapine: weight gain, hyperglycaemia, hyperlipidaemia.
• Risperidone: more prolactin elevation and EPSE than other atypicals.
• Quetiapine: more sedating.