Iloperidone is not recommended as a first-choice antipsychotic due to twice-daily dosing, slow titration requirements, QT prolongation (similar to ziprasidone), dizziness, moderate weight gain, increased blood sugar, and overall weaker efficacy compared to other agents.

Paliperidone is the active metabolite of risperidone.

Haloperidol is an effective, inexpensive first-generation antipsychotic (FGA) with low weight gain potential and a long history of use, but its clinical utility is limited by extrapyramidal symptoms (EPS) and the risk of tardive dyskinesia.

Nefazodone was once popular due to its low rate of sexual side effects, but its use has dramatically declined because of rare yet serious hepatic toxicity.

Topiramate is a reasonable off-label choice for alcohol use disorder and antipsychotic-induced weight gain.