What is the key difference between first-generation and second-generation antipsychotics?

The key distinction between first-generation and second-generation antipsychotics lies in their side effect profiles. Second-generation antipsychotics are generally associated with a lower incidence of extrapyramidal symptoms (EPS), which are movement disorders that can occur with first-generation antipsychotics. This reduction in side effects makes second-generation medications often more tolerable for patients, leading to improved adherence to treatment.

First-generation antipsychotics, while effective in treating symptoms of psychosis, particularly schizophrenia, are more likely to cause significant side effects such as tardive dyskinesia, akathisia, and parkinsonism. The development of second-generation antipsychotics aimed to reduce these risks while maintaining efficacy. Thus, the advantage of fewer side effects in second-generation antipsychotics is a primary reason they are preferred in many clinical situations.

While it is true that second-generation antipsychotics may be more expensive, this cost aspect is not a defining difference in their clinical use and effectiveness when compared to first-generation drugs. Additionally, the notion that first-generation drugs are only for schizophrenia is incorrect, as they can also be used for other conditions such as acute mania and certain mood disorders. Finally, the overall effectiveness of both generations can vary depending