What Are Second-Generation Antipsychotics?

Second-generation antipsychotics (SGA), commonly called atypical antipsychotics, are a type of drug that a doctor may prescribe for a range of psychiatric disorders. These medications may benefit patients with schizophrenia, bipolar disorder, or acute mania. Second-generation antipsychotics are called “atypical” to differentiate them from first-generation antipsychotics, which had a much higher risk of certain side effects, such as movement disorders. Despite the relatively reduced risk of side effects, patients should always discuss the possible complications with their doctors prior to use.

Some examples of second-generation antipsychotics include quetiapine, aripiprazole, and olanzapine. The directions for use will vary, depending on which medication the patient is prescribed, as well as the needs of the individual patient. These drugs may be available as tablets, as extended-release tablets, or as a liquid solution. Patients should follow all dosage instructions carefully, and they should not stop taking their prescribed drug abruptly without consulting their doctors. Abrupt discontinuation of a second-generation antipsychotic may lead to withdrawal symptoms like nausea, vomiting, and insomnia.

These antipsychotic medicines may cause some side effects, which should be reported to the prescribing physician if they become severe. Depending on the specific drug used, patients may experience drowsiness, weakness, and stomach pain or swelling. Nervousness, dizziness, and weight gain, along with an increased appetite have also been reported. Some second-generation antipsychotics may also cause indigestion, irritability, and missed menstrual periods, as well as loss of coordination, decreased libido, and unusual dreams.

More serious side effects require immediate medical care, such as seizures, fainting, or uncontrollable movements. Some patients may experience problems breathing or swallowing, uncontrolled protrusion of the tongue from the mouth, or a tightening of the throat muscles. Second-generation antipsychotics may also cause a high fever, chest pain, and a slow or rapid heartbeat. Muscle stiffness, changes in vision, and confusion may also occur, as well as a painful erection that lasts for several hours.

Before taking any antipsychotic medicine, patients should disclose their other medical conditions, medications, and supplements. Women who are pregnant or breastfeeding should discuss the potential risks with their doctors. These drugs may be contraindicated for use by those with diabetes, heart or liver disease, or a history of recreational drug use. Those with high cholesterol or blood pressure, an irregular heartbeat, or a history of stroke or heart attack may also be unable to take these drugs. Second-generation antipsychotics may interact with other medications, including antidepressants, antifungals, and antihistamines.