There are reports of increased mortality from antipsychotics in older adults. Now, we have a paper showing increased mortality in children, adolescents, and young adults aged 5–24 years. Given the frequent use, both on- and off-label, of antipsychotics, does this change how we use them? And if so, how?

Akathisia is a sensation of inner restlessness so unpleasant that it independently elevates the risk of suicide. Among atypicals, quetiapine (Seroquel) has the lowest risk of akathisia, but that doesn’t mean it’s easy to take.

Clozapine is often used as a last resort in schizophrenia, even though practice guidelines recommend a trial of this medication after failing 2 antipsychotics. The current study set out to test a treatment algorithm based on those guidelines in patients with first-episode psychosis.

Once patients with schizophrenia are stabilized on an antipsychotic in the acute phase of their treatment, guidelines are unclear on how to continue dosing. Some guidelines recommend lowering the dose, others recommend maintaining the dose, and others give no firm recommendations whatsoever.

A new study from Finland shows that lithium may be more effective than other treatments in reducing the risk of psychiatric rehospitalization in patients with bipolar disorder.

Metformin has been used off-label for weight loss in psychiatry for many years, much of it for help with adult weight gain as a side effect of atypical antipsychotics. However, most trials of metformin for weight loss were actually conducted on the child and adolescent population. This article will look at the quality of the data in our pediatric population of 3 studies, and then come up with some recommendations for your practice.

We publish an issue on antipsychotics at least once a year, and it’s always a challenge to decide what to cover. There are dozens of antipsychotics, and most of them are approved for mood disorders as well as psychosis.

For those reluctant to make clozapine their go-to antipsychotic for certain patients, this article will provide information to help you decide when it’s right to prescribe.