Which SGA is best tolerated for the treatment of schizophrenia?

Quetiapine is often considered one of the best-tolerated atypical antipsychotics (SGAs) for the treatment of schizophrenia due to its favorable side effect profile. It has a lower incidence of extrapyramidal symptoms (EPS) compared to some other SGAs, making it a good option, especially for patients who are sensitive to these adverse effects. Additionally, quetiapine has a unique pharmacologic profile, including a mixed antagonist activity at various receptor sites, which may contribute to its tolerability.

Patients on quetiapine are also less likely to experience significant weight gain or metabolic side effects compared to other antipsychotics like olanzapine. Furthermore, quetiapine can have sedative effects, which may benefit patients who also experience insomnia or agitation. Overall, its relative safety and tolerability make it a strong candidate for individuals with schizophrenia, especially those who may have had adverse reactions to other antipsychotic medications.