Cobenfy is a novel antipsychotic that acts through the muscarinic acetylcholine system rather than the traditional dopamine pathways.

Tried and true, risperidone’s moderate side effect profile has led to its wide use, and many clinicians consider it their antipsychotic of choice for first-episode psychotic disorders. 

Many consider olanzapine to be more effective than other antipsychotics and just below clozapine in overall efficacy. Its strong effectiveness, once-daily dosing, and low QT-prolongation risk are appealing.

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

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.