Ziprasidone has an appealing weight and metabolic profile, but many clinicians are overly cautious due to its reputation for QT interval prolongation.

Trifluoperazine, like thiothixene (Navane), is an effective older agent with similar potency to haloperidol or fluphenazine; however, given the wide range of antipsychotic options today, it is rarely used.

Thiothixene is one of the original high-potency first-generation antipsychotics (FGAs)—but most clinicians prefer fluphenazine or haloperidol due to greater familiarity and more formulation options (liquid, injectable, long-acting).

Thioridazine prolongs the cardiac QT interval more than any other antipsychotic, rendering it too risky for the majority of patients.

Pimavanserin is the only antipsychotic with virtually no dopamine receptor activity.

Perphenazine, first introduced in 1957, is an older first-generation antipsychotic (FGA) that became newly popular after the 2005 CATIE trial showed it to be as effective as most second-generation antipsychotics (SGAs) with minimal weight gain or metabolic problems. Many clinicians now consider it an effective, well tolerated, inexpensive alternative to SGAs.

Paliperidone is the active metabolite of risperidone.

Molindone is an effective, well-tolerated first-generation antipsychotic (FGA) of medium potency—a solid medication favored by some clinicians for select patients. It was recently reintroduced to the market and remains generic and inexpensive.

Lumateperone is the newest second-generation antipsychotic, approved for adults with schizophrenia or bipolar depression.