Compared with typical antipsychotics, what is a characteristic of atypical (second-generation) antipsychotics?

Compared with typical antipsychotics, what is a characteristic of atypical (second-generation) antipsychotics?

• A. Higher risk of EPS and TD
• B. No difference in side effects
• C. Lower risk of EPS and TD but higher risk of weight gain, DM, and dyslipidemia
• D. Lower risk of metabolic effects

Answer: (C)

The key idea is how second-generation antipsychotics differ in their receptor effects. They continue to block D2 receptors but also strongly antagonize serotonin 5-HT2A receptors. This combination lowers the risk of motor side effects in the nigrostriatal pathway, so extrapyramidal symptoms and tardive dyskinesia are less common than with typical antipsychotics that block D2 more purely. At the same time, the 5-HT2A-related and other pharmacologic actions contribute to metabolic changes, leading to weight gain, insulin resistance or diabetes, and dyslipidemia. So, these drugs tend to have a lower risk of EPS and TD but a higher risk of metabolic problems like weight gain, diabetes, and dyslipidemia. The other statements don’t fit because they either overstate EPS risk, claim no difference, or assert metabolic effects are lower, which contradicts the typical profile of second-generation antipsychotics.

The key idea is how second-generation antipsychotics differ in their receptor effects. They continue to block D2 receptors but also strongly antagonize serotonin 5-HT2A receptors. This combination lowers the risk of motor side effects in the nigrostriatal pathway, so extrapyramidal symptoms and tardive dyskinesia are less common than with typical antipsychotics that block D2 more purely. At the same time, the 5-HT2A-related and other pharmacologic actions contribute to metabolic changes, leading to weight gain, insulin resistance or diabetes, and dyslipidemia. So, these drugs tend to have a lower risk of EPS and TD but a higher risk of metabolic problems like weight gain, diabetes, and dyslipidemia. The other statements don’t fit because they either overstate EPS risk, claim no difference, or assert metabolic effects are lower, which contradicts the typical profile of second-generation antipsychotics.