Antipsychotics

Second-generation	First-generation
Amisulpride	Chlorpromazine
Aripiprazole	Flupenthixol
Asenapine	Fluphenazine
Clozapine	Haloperidol
Paliperidone	Pericyazine
Quetiapine	Trifluoperazine
Risperidone	Zuclopenthixol
Sertindole
Ziprasidone

The original distinction was that second-generation agents cause fewer extrapyramidal/movement-disorder side effects but more significant cardiometabolic effects. Neither group behaves as a single uniform class — individual drugs vary considerably in their side-effect profile, so prescribing and monitoring should be tailored to the specific agent (see eTG/AMH for current dosing — subscription content, cite by name only).

Metabolic monitoring (baseline and ongoing: weight/BMI, waist circumference, blood pressure, fasting glucose/lipids, and specific ECG/prolactin monitoring where relevant to the agent) is a core prescribing obligation, set out in the RANZCP Schizophrenia CPG — see Schizophrenia for the antipsychotic dosing algorithm in first-episode psychosis.