Neuroleptics may produce a wide-range of side effects depending on the potency and class of neuroleptic medications prescribed. High-potency, first-generation neuroleptics, such as haloperidol and fluphenazine, are likely to produce extrapyramidal symptoms, which are movement disorders caused by medications. Examples of extrapyramidal symptoms include muscle spasms (i.e., acute dystonia), motor restlessness (i.e., akathisia), and parkinsonism, which is characterized by instability, shuffling gait, and muscle rigidity. Tardive dyskinesia is another extrapyramidal effect, characterized by involuntary, repetitive movement, such as smacking lips or waving arms. Tardive dyskinesia may occur after long-term use of the medication and can be irreversible. Neuroleptic malignant syndrome is a rare, potentially fatal extrapyramidal side effect, presenting with symptoms such as confusion, muscle rigidity, seizures, coma, agitation, and hyperthermia and requiring immediate medical attention. Additional potential side effects of high-potency, first-generation neuroleptics include an increased time between heart beats and metabolic symptoms, such as weight gain and high cholesterol. Low-potency, first-generation neuroleptics, such as chlorpromazine and thioridazine, will commonly result in side effects similar to those seen with anticholinergics, which are medications that block the neurotransmitter acetylcholine. These side effects may include dry mouth, sedation, constipation, and dizziness. In general, low-potency, first-generation neuroleptics are less likely to cause extrapyramidal symptoms.  Second-generation neuroleptics are associated with fewer extrapyramidal and anticholinergic side effects. They can, however, lead to weight gain, drug-induced type 2 diabetes, and tiredness. Due to the many potential side effects, neuroleptics may not be recommended for people with heart disease, liver damage, Parkinson’s disease, low levels of white blood cells, or severe depression. Consultation with a healthcare professional is advised when deciding whether neuroleptics are a viable treatment option.