What is a common risk associated with first-generation antipsychotics (FGAs)?

The common risk associated with first-generation antipsychotics (FGAs) is a higher risk of extrapyramidal side effects (EPS). This group of medications, which includes drugs such as haloperidol and chlorpromazine, is known for its effectiveness in treating positive symptoms of schizophrenia but is also notorious for causing movement-related side effects. EPS includes symptoms like tremors, rigidity, bradykinesia, and tardive dyskinesia, which can be distressing and impact a patient's quality of life.

The pharmacological mechanisms that lead to EPS are primarily related to the blockade of dopamine D2 receptors in the striatum, which is a key area in the brain responsible for coordinating movement. While FGAs may be robust in managing certain psychiatric symptoms, their side effect profile poses significant clinical challenges that must be carefully managed.

In contrast, second-generation antipsychotics, although they can also experience EPS, tend to present a lower risk, which is one reason they are often preferred in clinical settings. While other risks such as metabolic syndrome and the need for dosage adjustments may be relevant considerations for both classes of antipsychotics, they do not characterize the inherent risk profile of FGAs as definitively as the risk of EPS