Antipsychotics are most frequently used to treat psychotic disorders, such as schizophrenia, schizoaffective disorder, and delusional disorder.  Some antipsychotics also function as mood stabilizers or can be used to augment treatments for other disorders, such as depression

Atypical Antipsychotics (Second Generation)

  • Aripiprazole (Abilify, Abilify Maintena, Aristada); Usual Daily Dosage Range: 15-30 mg (Oral), 400 mg every 4 weeks (Abilify Maintena); 441 mg or 662 mg or 882 mg every 4 weeks or 882 mg every 6 weeks (Aristada)
  • Risperidone (Risperdal, Risperdal Consta); Usual Daily Dosage Range: 2-8 mg (Oral), 25-50 mg every 2 weeks (Long-acting Injection)
  • Olanzapine (Zyprexa, Zyprexa Relprevv); Usual Daily Dosage Range: 10-20 mg (Oral), 10-20 mg (Short-acting Injection); 150-300 mg every 2 weeks or 300-405 mg every 4 weeks (Long-acting Injection)
  • Quetiapine (Seroquel, Seroquel XR); Usual Daily Dosage Range: 400-800 mg (Oral)
  • Ziprasidone (Geodon); Usual Daily Dosage Range: 40-200 mg (Oral); 10-20 mg (Short-acting Injection)
  • Clozapine (Clozaril); Usual Daily Dosage Range: 300-450 mg (Oral)
  • Paliperidone (Invega, Invega Sustenna); Usual Daily Dosage Range: 6 mg (Oral), 39-234 mg every 4 weeks (Long-acting Injection)
  • Asenapine (Saphris); Usual Daily Dosage Range: 10-20 mg (Sublingual tablet)
  • Lurasidone (Latuda); Usual Daily Dosage Range: 40-80 mg (Oral)
  • Iloperidone (Fanapt); Usual Daily Dosage Range: 12-24 mg (Oral)
  • Brexpiprazole (Rexulti); Usual Daily Dosage Range: 2-4 mg (Oral)
  • Cariprazine (Vraylar); Usual Daily Dosage Range: 1.5-6 mg (Oral)

Possible side effects include increased risk for diabetes mellitus and dyslipidemia, dizziness, sedation, dry mouth, constipation, dyspepsia, weight gain, extrapyramidal symptoms, chest pain, abnormal gait, ecchymosis, tachycardia, orthostatic hypotension, rare tardive dyskinesia,  hyperglycemia (in some cases extreme and associated with ketoacidosis or hyperosmolar coma or death), rare neuroleptic malignant syndrome, rare seizures, and increased risk of death and cerebrovascular events in elderly patients with dementia-related psychosis. 

In order to receive Zyprexa Relprevv, patients must participate in the Zyprexa Relprevv Patient Care Program.  Patients must be observed for at least 3 hours after receiving the injection due to concerns about post-injection delirium/sedation syndrome (PDSS).  

Patients must be enrolled in a Clozapine monitoring program in order to receive Clozapine due to the risk of agranulocytosis.

Typical Antipsychotics (First Generation)

  • Haloperidol (Haldol); Usual Daily Dosage Range: 1-40 mg (Oral), 2-5 mg every 4-6 hours (Short-acting Injection), 10-20x oral dose every 4 weeks (Long-acting Injection)
  • Chlopromazine (Thorazine); Usual Daily Dosage Range: 200-800 mg (Oral)
  • Thioridazine (Mellaril); Usual Daily Dosage Range: 200-800 mg (Oral)
  • Perphenazine (Trilafon); Usual Daily Dosage Range: 12-64 mg (Oral)
  • Loxapine (Loxitane); Usual Daily Dosage Range: 60-100 mg (Oral)
  • Trifluoperazine (Stelazine); Usual Daily Dosage Range: 15-20 mg (Oral), 1-2 mg every 4-6 hours (Short-acting Injection)
  • Fluphenazine (Prolixin); Usual Daily Dosage Range: 1-20 mg (Oral), 1/3-1/2 oral dose (Short-acting Injection),  12.5-50 mg every 3-6 weeks (Long-acting Injection)
  • Pimozide (Orap); Usual Daily Dosage Range: 2-10 mg (Oral)
  • Thiothixene (Navane); Usual Daily Dosage Range: 15-30 mg (Oral)
  • Molindone (Moban); Usual Daily Dosage Range: 40-100 mg (Oral)
  • Mesoridazine (Serentil, Lidanil); Usual Daily Dosage Range: 100-400 mg (Oral), 25-200 mg (Short-acting Injection)

Possible side effects include neuroleptic-induced deficit syndrome, akathisia, extrapyramidal symptoms, Parkinsonism, tardive dyskinesia, galactorrhea, amenorrhea, dizziness, sedation, dry mouth, constipation, urinary retention, blurred vision, decreased sweating, sexual dysfunction, hypotension, tachycardia, syncope, weight gain, QTc prolongation, ventricular arrhythmia, rare neuroleptic malignant syndrome, rare jaundice, agranulocytosis, rare seizures, and increased risk of death and cerebrovascular events in elderly patients with dementia-related psychosis.

Usual daily dosage range is for adults.  The above information is meant as a general reference only and should not be used as a guideline for prescribing of medications or medical advice.  Please check the manufacturer’s product information sheet or the P.D.R. for the most accurate information, including dosage schedule, side effect profile and contraindications.  Please consult a physician for medical advice.  Brand names are registered trademarks.  Disclaimer